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<br />--~'C'~~.,", <br /> <br />' ~ ,'~fJI1I'" <br /> <br />r <br /> <br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYIUIILLS <br />BUILDING DBPARTllBNT <br /> <br />'.a. <br /> <br />OWNER'S NAIIIL..l)) \ ~),~, \?- <br />OWNER'S ADDIlBSS ~I S2~ <br /> <br />JOB ADDRESS <br /> <br />~~-)\:1" <br /> <br />C'~(\ <br />$\ ~~\J <br />3, <br /> <br />. <br /> <br />PHON! ~\~) (~~ -:t:.so ~ <br />~ ~~'V~\'\~' \=1 <br />0:L~b ~V /~~~J7i, <br />~ <br /> <br />LEGAL DESCIUP'lION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D.' (OBTAIN FROH PROPERTY TAX NOTICE) <br />WORK PROPOSED:---.Jiew Goostruction ---^ddition ~teration --Repair' _Install <br /> <br />---1Jigo <br /> <br />--.JIove <br /> <br />---Peaolish <br /> <br />BUILDING SIZB: <br /> <br />x <br /> <br />. <br /> <br />Square Feet, <br /> <br />RESIDENTIAL: AtTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SIT BaG!' FORKS. <br />COtlKERCIAL: ArlACII (3) SETS OF BUILDING PLANS &: (1) SBT BNERGY FOlUlS., <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERH.I.TS REQUESTED <br /> <br />--BUILDING <br /> <br />$. Valuation of Total Construction <br /> <br />;" <br /> <br />RI.RC1'RlCAL <br /> <br />AIIP Service Florida Power Corp. <br /> <br />W.R.I.C. <br /> <br />---llEQWIlCAL <br /> <br />$. <br /> <br />Valuation of llecbao.ical lDstall.ation <br /> <br />---JJLUHBIRG <br /> <br />GAS ROOFlBG <br /> <br />SPICIALU . <br /> <br />TYPB ~F COBSDUenOB: <br />FIRISIIED FLOO1l ELEVAUOBS: <br /> <br />lUocIt --.Jr_e --.-Steel <br /> <br />Other <br /> <br />FI'. <br /> <br />IS PlWJBCI' IN FLOOD ZONB AREA., , <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />, " <br /> <br />co~ SIlCTIOB .. ~.:. . <br />" WltPAllrJ- E, me <br />. ' <br />State Cert. or Reaist. . . <br />City License Reai~tratiOD . Ll7 <br />.......................................... <br /> <br />. " <br /> <br />BIITI.QRR. <br /> <br />,'. <br /> <br />Sisnature <br /> <br />~ :~~' COtIPANY~~ <br />. $ State Cert. or Regist.' 1=-/1'1- <br />~ . O~.ff'a City Licease Realstrstlon' '11 <br />I ... ..................................... <br /> <br />,f!T . <br /> <br />PLIIl8IlIl ~. COIIPAIIr Loe.~ l)o~ <br />. . .' State Cert. or Reaist. . <br />s.......turec- ~J) -~ City Lie...... Jlea,lstrstlon . <br />... . .................................. . <br /> <br />I~b <br /> <br />IlECllANIGAt COMPANY <br />State Cert. or Reaist. , <br />Si80ature City License Registration . <br />.......................................... <br /> <br />j' ~"; <br /> <br />OTHRR GOHPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />.......................................... <br /> <br />APPLlCAnOB APPBOVID BY PBBHIT OFFICII. <br />