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<br />APPLICATION FOR PERKlT <br />CITY OF ZEPIIYlUIILLS <br />BUILDING DEPARTHEHT <br /> <br />OWNER'S ADDKBSS <br /> <br />It H SI;I-/ I+Df.? i?- <br />f <br />S'lf33 197"-H S I <br />, ~L/,~ 3 J 9 rH s r <br /> <br />PHONE <br /> <br />8f3- <br /> <br />7J'~ - 33 y.>- <br /> <br />OWNER'S IiAHB <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCIL--SUBDIVISION <br /> <br />PARCEL IoD.' (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:~ew Construction ~ddition ~eration ---Repair _Install <br /> <br />PROPOSED USE: <br /> <br />_Sign <br /> <br />~iog1e Faaily <br /> <br />--.JIove <br /> <br />--Peaolish <br /> <br />-.Jt/F <br /> <br />_' of Units <br /> <br />----1f/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />Restaurant Ii: Health Departaent Approval <br />DESCRIPTION OF WORK:_R ~ J) '-14- cJi: f.I t;: 14- T <br />, <br /> <br />:pu~ <br /> <br />SY5rr::-~ <br /> <br />, <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDERTIAL: A'lTACII (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET DERGY FORKS. <br />COMKERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />tv ~UILDING <br />IV ty IU.RcruCAL <br />V HEClWlICAL <br />TvLPLUHBING <br /> <br />$ <br /> <br />AIIP Service Florida Power Corp. <br /> <br />W.R.B.C. <br /> <br />$ <br /> <br />:J48D <br /> <br />Valuation of Itechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY . <br /> <br />TYPE OF mllsTRucnoN: ~loclt _Fraae _Steel <br /> <br />Other <br /> <br />FDlISBED FLOOR ELEVATIOIIS: <br /> <br />Fl. <br /> <br />IS PROJEC'l IN FLOOD ZONE AREA! <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />PLUMBER <br /> <br />/VA <br /> <br />III It <br /> <br />State Cert. or Regist. . <br />City License Registration . <br />;v.~~.............:::::::.............;ii:i ~ <br /> <br /> <br />~ State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />COMPANY .IV if}- <br />State Cert. or Resist. . <br />City License Registration . <br />.......................................... <br /> <br />;Uttl <br /> <br />CONTRACTOR SECTION <br /> <br />.' <br /> <br />RUTT llER <br /> <br />cOMPANY <br /> <br />Signature <br /> <br />IU.RCTRICIAII <br /> <br />SignAture <br /> <br />Signature <br /> <br />HECllANICAL~~/ COMPANY SOU \H ~~ L(:) "'-+o,,-T <br />State Cert. or ReSist.' R "... 00 I s-c 2... ~ <br />Signature . City License Registration f J J () <br />.............. ........................... <br /> <br />COMPANY JIL/ Y-1 <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />OTRRR <br /> <br />Nit <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />