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<br />APPLICATION FOR PERHIT <br />CITY OF ZEPIIYRB.ILlS <br />BUILDIRG DEPARTHERT <br /> <br />OWIIBR' S __ t~(f c G.j.U(~ ~ a.. ~J.A!Lhh PIIOHE 7'1 ( - ') '<(, b <br />OWNER'S ADDllESS' I )0 s ( ~ E5 ,9o-t,0-./~ <br />Q,rr Va" I lJ :J () <br />~:~: :::~) ~MV~ ::.~ SUBDIVISION ~" ()aN <br />~103C:>O' . <br />PARCEL LD.' .3 -~b-;)/ - 0/ GO~ O(XX):]~ (!p~~~ (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED :bew Construction --Addition ------Alteration --.Jepair _Install <br /> _Sign ------",ove -->>eaolish <br />PROPOSED USE: XSingle Faaily ------",IF _' of Units ---1l/B <br /> _ec-ercial _IDdust. _Swia. Pool _Other <br /> <br />. ~estaurant Ii: Health Departaent Approval <br /> <br />. g'~ ,1 ~ l1;'li <br />! / -, I, I . r ( II l ", <br />DESCIUPTIOII OF~: n L\"B~ ",wv'(j - L'-t'WAl <br />BUILDING SIZE: X, Square Feet, B ight p~~ <br /> <br />PUt /' <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLARS Ii: (2) SETS OF BUILDIRG PLANS Ii: (1) SET ENERGY FORMS. <br />COMMERCIAL ATTACH (3) SETS OF BUlLDIRG PLANS Ii: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />RI.RCTRI.CAL <br /> <br />-/. <br />$ ~) ~'> , Ct'Y:> <br />./ <br />ISO <br /> <br />Valuation of Total Construction <br /> <br />'f <br /> <br />-BUILDING <br /> <br />---..PLUMBING <br /> <br />AIIP Service X' Florida Power Corp. <br />. <br /> <br />$ 3,000 Valuation of Mechanical Installation <br />~, <br />,!.JL./~W ROOFING <br /> <br />_Fraae _Steel <br /> <br />W.R.E.C. <br /> <br />-----1IECllAlUCAL <br /> <br />TYPE OF CORSTRUcnON: <br /> <br />GAS <br />block <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FIllISBED FLOOR ELEVATIORS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />Signature <br /> <br /> <br />CONTRACTOR SECTION" <br /> <br />aJIIPAIIY ~ (L:PY~ i:~QAH4 <br />State Cert. r Regist. 4'::;~- <br />City License Registration f (.""...,G C ::.</-;;': ;:;,'(') <br />......*****..*****..**....*..*..... <br /> <br />RIJJLDER <br /> <br />/' - <br />RI.RCTRICIAR COMPANY ,)' oL ~ L~/~(/T (-<> -t/J C- <br />~ #. ~ State Cert. or lle&ist.' PI< t),,,,, .2 C> l/L <br />SignAture ,~ . City License Registration'. '2- 1/5- <br />......................................... ' <br /> <br />PLUMBER COMPANY #0/VYI1!J,v f-~1 tfio~/~J <br />~ / v <br />. ~ . State Gert. or lle&i.t. . dF "'" -3 (# t':. / / <br />Sigoat . ~~ ~ ity License Registration' /~..s-- <br />. .............~..................... <br /> <br />IIEGllAnCAL ~ aJIIPAIIY ARC-Ale.- c, Pc. <br />I . State Cert. or Regist. . C,tqC-,b 31.. 'f'f7 <br />Signatur~. City License Registration' I S;-( <br />.............*..*......................... <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.....*.......*............................ <br /> <br />OTRRR <br /> <br />Signature <br /> <br />APPLICAnOll A1'FJIOV1lD BY 71 ~ ltJ ~ ~ <br /> <br />PERMIT OFFICER. <br />