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<br />" <br /> <br />" <br /> <br />APPLICAnON FOR PERKIT <br />CITY OF ZEPIIYRIIILLS <br />BUILDIRG DEPARTMENT <br /> <br />OWNER' S NAHE <br /> <br />If If(( (j ({) <br />3 'b?' (5" <br />~ T Ie> <br /> <br />~ L-~Y. <br />1'''11 I /L/ <br />~S/,J6 . /(7/ <br /> <br />Scu;?y <br />! <br /> <br />PHONE <br /> <br />'7s? do CIa <br /> <br />OWNER' S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />16 (,Cd &J ?rT: <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOC1L..-SDBDIVISION <br /> <br />PARCEL LD.' (OBTAlN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:~ew Construction ~ddition ------Alteration ---.Jlepair _Install <br /> _Sign --.Jlove ->>eaolish <br />PROPOSED USE: ~iog1e Faaily -.-Jt/F _' of Units -.-Jt/H <br /> _ec-ercial _IDdust. _Swia. Pool _Other <br /> <br />--.Jestaurant Ii: Health Departaent Approval <br /> <br />DESCRIPTIOII OF WORK: <br />BUlLDIRG SIZE: c; x~3, <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLARS Ii: (2) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FORKS, <br />ATTACH (3) SETS OF BUILDIRG PLANS Ii: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW COIISTRUCTION. <br /> <br />-BUILDIRG <br /> <br />$ <br /> <br />6 <::{ I (jV <br /> <br />PERMITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />--.JIEClWlICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLtllBING GAS ROOFING <br />TYPE OF COIISTRUcnON: ___lock _Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FDISBED FLOOR. ELEVAnONS: <br /> <br />Fl. <br /> <br />IS PROJEct IN FLOOD ZOBE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />RUTI.DRR <br /> <br />CONTRACTOR SECTIO, ) <br />COHPAIIY C::> 0 J~--;e. <br />- A .//? ~ State Cert. or Regist. . <br />[~~ City License Registration .. <br />.......................................... <br /> <br />rfC () I( (I() rJ '7' <br />77 <br /> <br />Signature <br /> <br />RI.RCTlUCIAIJ COMPANY <br />State Cert. or Regist. . <br />SiQDAture City License Registration . <br />.......................................... <br /> <br />PLtllBER COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration . <br />.......................................... <br /> <br />HECHARICAL COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration , <br />.....................................~*... <br /> <br />APPLICAnOR APPROVED BY PERKIT OFFICER. <br />