Laserfiche WebLink
<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYRIIILLS <br />BUILDING DEPARTKENT <br /> <br />OWNER'S HAHE c;f:t3I-\-CV() ~l'-' ~TrtuCr.' ~ A.I XN C. <br />OWHER' S ADDRESS 112> S ~ :( \ ~-r 3-\./K.. ~ +- <br /> <br />PHONE <br /> <br />o,olf <br /> <br />5'2./-'0701 <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />10 <br /> <br />B~SUBDIVISION Oft\<. ~:2.yt~::::'T <br /> <br />PARCEL LD.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED: '/New Construction --..Addition ---Alteration --Repair _Install <br /> <br />_Sign <br /> <br />--Hove <br /> <br />-Deaolish <br /> <br />PROPOSED~E: ~s~eF_ilY <br /> <br />_"-IF _' of Units _"-/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />---..Restaurant &: Health Departaent Approval <br />DESCRIPnON OF WORK:J~t.0 )2~ 'S>\ l)~~lc..e - (fY\oreL H-orne ') <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />;, ro"f' Square Feet, <br /> <br />Height <br /> <br />RE5IDEIITIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORKS. <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.RC1"RICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---lIEClWlICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />~ING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _B1oclt _Fr_e _Steel <br /> <br />Other <br /> <br />FDlISHED FLOOR ELEVAnONS: <br /> <br />FT. <br /> <br />IS PROJEct IN FLOOD ZONE AREA'I <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />RITrT.Dg ~ ~~' mKPAIiY 0f.gHJ4.r?i (!CJ>>5f'f?-v'-rr.o~ , ,1Ue..... <br />( r1/"-;/)/J State Cert. or Regist.' f,<ft ~~l )f-~ <br />Signat~ I/~ JI.f;.".,.r-- City License Registration' c'Ho <br />~J .......................................... <br /> <br /> <br />=~~~ COMPANY ~ T. <br />. State Cert. or Regist. . <br />City License Registration . . <br />.......... ............................ <br /> <br />PLUMBER. - 22 Q62 ~ COKPANY ~Vlrao"'EJfJT"l. CLv- <br />t- State Cert. or Regist. . ~C!.. (9 :3 717 I <br />Signature '\ . City License Registration . q (p . <br />.......... ............................ <br /> <br />IlECBABICAL. rl2 ~ COMPANY 6IJI'l?nJ()Jt{IUJTItI ('-~,r- <br />'t State Cert. or Regist. ,~. ~ 938' a-... <br />.Signature _ City License Registration' '+4 <br />.......... ............................ <br /> <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />APPLICATIQB APPIlOVED BY '114?1A'~ )11"..".,..t ~ <br /> <br />PERKIT OFFICER. <br />