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<br />APPLlCAnON FOR PERKIT <br />CITY OF ZEPIIYIUIILLS <br />BUILDING DEPAR'l'HENT <br /> <br />OWNER'S lWIE t ItZCiF K L'CJRP . <br />OWER'S ADDllBSS Sh/'JO I3R6C!.k.GlV~oGG" I?~IC (),<l- <br />JOB ADDRESS l;(C)} ~.f<. 6'1 ~ ~""oI<G *"7/'3'D <br /> <br />PHONE <br />~ <br /> <br />6;2/-554 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCX...--SUBDIVISION <br /> <br />PARCEL I.D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:-'iew Construction ---..Addition ---..Alteration ~pair _Install <br /> oe. <br /> _Sign --.-Nove ---Peaolish Re:YH!-F <br /> .L19H-li#(j <br />PROPOSED USE: ~ing1e Faaily --.Jt/F _' of Units --.Jt/B <br /> _ec-ercial _Iodust. _Swia. Pool _Other <br /> <br />--..Restaurant &: Health Departaent Approval <br />DESCRIPTIOR OF WORK: L/~~7//V'5 /l~-rd- UPt9R;90E PER ~~e-6 S~t~AI. <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />. <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENlmGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKI.TS REOUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />., RT.RcnuCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-.JIECllAlllCAL <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />----PLUHBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF COBSDUC'l10N: -----.BlocIt _Fraae _Steel <br /> <br />Other <br /> <br />F1IIISBED F100R BLEVAnOBS: <br /> <br />Fl. <br /> <br />IS PROJEC'I' IN FLOOD ZORE AREA! <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />RIJJlJlD <br /> <br />Signature <br /> <br />COHPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />RT.RCTIUCIAR <br /> <br />COMPANY ~ PE(!7RIC!. ~t' . <br />State Cert. or Regist. . ECC~~2t'k. <br />City License Registration' ~ g <br />.......................................... <br /> <br />Si-ture <br /> <br />PLIDIBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />IlECllANICAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration f <br />.......................................... <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />}1 MV' q J11 fr1r l (j PIlIIIIIT OFFICER. <br /> <br />Signature <br /> <br />APPLlCAnON APPROVED BY <br />