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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYRBILLS <br />BUILDING DEPARTHENT <br /> <br />OWNER'S ADDRESS <br /> <br />!-/.R N Y 4-hY <br />s;- S-C-/7 J.. 4 i/" V <br /> <br />/ <br /> <br /><) Lb'n e <br /> <br />PHONE <br /> <br />787--9('// <br /> <br />OWNER'S NAHB <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1.D.' <br /> <br />(OBTAIN FR.OK PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction ----..Addition ---.J\1teration ~pair -_Install <br /> <br />_Sign <br /> <br />--.-JIove <br /> <br />----Peaolish <br /> <br />PROPOSED USE: _Single F_ily <br /> <br />--.-JI/F _' of Units --.-JI/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />DESCRIPTION OF WORK: <br /> <br />--Restaurant at Health Departaent Approval <br /> <br />4;LL <br /> <br />J <br /> <br />---- <br />I ..:TIN <br /> <br />BUILDING SIZB: <br /> <br />x <br /> <br />. <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RBSIDBBTIAL: <br />COMMERCIAL : <br /> <br />A'nACB (2) PLOT PLANS at (2) SETS OF BUILDING PLANS at (1) SET ENERGY FORMS. <br />A'nACB (3) SETS OF BUILDING PLANS at (1) SET ERERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS RBOUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />RT-ECTRICAL <br /> <br />----"ECIIAlII.CAL <br />~1IIBING <br /> <br />$ <br /> <br />AIIP Service <br />c2 'i q s-:- 00 <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />Valuation of Kechanica1 Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPB OF COBSTRUctION: ~loc1t _Fraae _Steel <br /> <br />Other <br /> <br />FI1IISBED FLOOR ELEVAnONS: <br /> <br />Fr. <br /> <br />IS PROJECT IN FLOOD ZONE AREAT <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />BUTI.Dm <br /> <br />RIRCTRTCIAIJ <br /> <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />t1C(fb~ <br /> <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />iA./tv <br /> <br />COMPANY <br /> <br />G: (t,e(t ;~ <br />.,.~I <br /> <br />PLUMBER <br /> <br />Signature <br /> <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.............................~............ <br /> <br />COIPAIIY /-tV -Iv ~ JI./ L-..a- r:fr ~ <br />State Cert. or Rea!st. . (f) O.J~ '1'-< <br />City License Registration . 7/ <br />.......................................... <br /> <br />Signature <br /> <br />KECllABIGAL <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PBRHIT OFFICER. <br />