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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYRIIILIS <br />BUILDING DEPARTMENT <br /> <br />OWNER' S NAME <br /> <br />. Te c; n <br /> <br />)1e- Cc y <br /> <br />, <br /> <br />Le;zy <br />/ <br /> <br />PHONE g I.? .... <br /> <br />/23-);?G-lo <br /> <br />OWNER' S ADDBESS ..J ,;? 3' J ? <br /> <br />L 47 ,c~ /J <br /> <br />JOB ADDRESS .5'i ,1'7 L- <br /> <br />LEGAL DESCRI.P'llON: LOT(S) <br /> <br />BLOCIt......-.SUBDIVISION <br /> <br />PARCEL LD.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction ----^ddition ----ft1teration _Repair _Install <br /> <br />_Sign <br /> <br />----lfove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Fsaily <br /> <br />----1't/F _' of Units ----1't/H <br /> <br />_~ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />-Restaurant Ii: Hea1th Departaent Approval <br /> <br />DESCRIPTIOII OP WORK: <br /> <br />BUILDIIIG SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS Ii: (2) SETS OF BUILDING PLANS Ii: (1) SET ENERGY PORMS. <br />ATTACH (3) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REQUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />/ <br />-1L...JtEClWlICAL <br /> <br />$ 2 7 / r;, ~ Valuation of Mechanical Installation <br /> <br />-PLUMBING GAS ROOfiNG <br /> <br />SPECIALTY <br /> <br />TYPE OP COIISTRUcnOR: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FDlISBBD nooR ELEVAnOIlS: <br /> <br />FT. <br /> <br />IS PROJEct IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CORTRActOR SEctION <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />BUYlDO <br /> <br />Signature <br /> <br />SianAture <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />RT .R.CTRTCT All <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration , <br />.......................................... <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />MECllARICAL <br />Signature ..J~r <br /> <br />COKPANY 15 T C c:; 1/ !li,5, 't C 1:7~ 1- <1 L- <br />;:7~ ' - State Cert. or Regist. ,CI/C tY3..1rS7'3' <br />:. '''V~--r-= City License Registration f /5. r <br />.......................................... <br /> <br />OTRR.R COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />.......................................... <br /> <br />APPLICATIOII APl'IlDVBD BY )f ~ ~ IJ1 ,hy~ PEIlH1T OFFICER. <br />