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<br />APPLICAnON FOR PERKIT <br />CITY OF ZEPIIYIUIILLS <br />BUILDING DEPAR'J.'HENT <br /> <br />OWNER' S IWIK ffi \ ck\.~' ~~ <br />OWNER' S ADDRESS ~"I S ~ <br />lo~~ \- <br /> <br />JOB ADDRESS <br /> <br />~(\ <br />~ ~~ <br />S~ <br /> <br />, <br /> <br />==x:+ <br /> <br />PHONi~\~)(~t, :t~a~ <br />~~"O~\\., '\;"L- <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCIL--SUBDIVISION <br /> <br />PARCEL I.D.' (OBTAIN FROM. PROPERTY TAX NOTICE) <br />WORK PROPOSED:~ew Construction ~ition bteration -.-.Repair _Install <br /> <br />_Sign <br /> <br />---lfove <br /> <br />->>eaolish <br /> <br />_ec-ercial <br /> <br />--.-Jt/F _' of Units --.-Jt/H <br />~Indust. _Swill. Pool _Other <br /> <br />PROPOSED USE: ~iDg1e Faaily <br /> <br />__Restaurant .. B~ Depar1t APP~al <br />DESCRIPTION OF WORK: bo-\0 C'(\~ ~ S ~ <br /> <br />BUILDING SIZE: X Square Feet. Height <br /> <br />60R- <br /> <br />J7 <br /> <br />RESIDEIITUL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REOUESTED <br /> <br />---BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />RT .R.ct'RI.CAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---lIEClWlICAL <br /> <br />$ <br /> <br />Valuation of Hecbanical Installation <br /> <br />-PLUMBING GAS ROOFING <br /> <br />SPECIALTY . <br /> <br />TYPE OF COBSTRUCTION: ___lock _Fraae _Steel <br /> <br />Other <br /> <br />FDlISBED F.LOOll ELEVAnONS: <br /> <br />FT. <br /> <br />IS PROJEct IN FLOOD ZONE AREAT <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRA~O~ S:Ecrm/l .~ <br />.cotIPAIIY_LB. mC~ <br />State Cert. or Regist. t <br />City License Registration . Lj 7 <br />.......................................... <br /> <br />RUTI .DER <br /> <br />Sigoature <br /> <br />..' :~~ COMPANY ff\f\t:=T1'\~ <br />/ J 4 -La State Cert. or Regist.' t=:.//Cf <br />A . U / /6i7~ City License Registration' t.t / <br />. ...~..................................... <br /> <br />PLUMBER . COKPANY Lo~ ~~ <br />c-3 ~ ~ State Cert. or Beaist. . <br />Sigoature _ City License Registration . <br />~ .... .................................. <br /> <br />I:?.~ <br /> <br />IlECHANICAL COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />OTR'RR COMPANY <br />State Cert. or Regist. . <br />Sigoature City License Registration . <br />.......................................... <br /> <br />APPLICATION APPBOVBD BY PERKIT OFFICER. <br />