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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYRIIILLS <br />BUILDIRG DEPARTHERT <br /> <br />OWRER'S ADDRESS <br /> <br />rV& t t1 ~/), fj 6t11.? A <br />~g5C> Ilft,~-!-_ <br />.So P/?J / <br />LEGAL DESCRIPTION: LOT(S) J I 1 ~ BLOCIL--SUBDIVISION <br />&/'/U <br />PARCEL LD.' II - .2 0 - ;;LJ - (:) cJ / 0 -- Od ~ () 0 "'{OBTAIN FROK PROPERTY TAX NOTICE) <br />WORK PROPOSED :.-Rew Construction ~ition ------Alteration --.Jepair _Install <br /> <br />PHONE f! /1 - 7 S "? - BOtJ1 <br />~1C0J7h~Jr)f)///C: Fk~ <br />- I . <br /> <br />OWNER'S HAHE <br /> <br />JOB ADDRESS <br /> <br />_Sign <br /> <br />-----1fove' <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />------"'F _' of Units _K/H <br /> <br />_ec-ercial <br /> <br />_IDdust. _Swia. Pool _Other <br /> <br />--.Jestaurant Ii: Health Departaent Approval <br /> <br />BUILDIRG SIZE: 1 t5 <br /> <br />/t:JIy~fJ / ~ L/p~:3 ~CJ~P? <br />. <br /> <br />X :< I'J , ;Z t1J() Square Feet, '7/ Height <br /> <br />DESCRIPTIOR OF WORK: <br /> <br />RESIDERTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLARS Ii: (2) SETS OF BUILDING PLANS &: (1) SET EURGY FORMS. <br />ATTACH (3) SETS OF BUILDIRG PLANS Ii: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CORSTRUCTION. <br /> <br />~LDIRG <br />_ELECTRICAL <br /> <br />PERMITS REQUESTED <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />~CllAllICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUKBING <br /> <br />GAS <br /> <br />ROOFlRG <br /> <br />SPECIALTY <br />/l iJ.il.~<ra;((lOther <br /> <br />TYPE OF mRSTRUCTION: _Block _Fraae _Steel <br /> <br />FDJISHED FLOOR ELEVAnORS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? ~ <br />YES NO <br /> <br />.......................................... <br /> <br />CORTRACTOR SECTION <br /> <br />RIJTUlRR <br /> <br />_ \ f) COMPANY <br />.~ ... fro ~ State Cert. or Regist. . <br />~~ ~ City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />RI.RCTRICIAII <br />SignAture ~ <br /> <br />COMPANY <br />(~ State Cert. or Regist. . <br />~~ ~ City License Registration' <br />.......................................... <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />..............***.*****.**.....**.***.*... <br /> <br />PLUKBER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />KECllARICAL <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.................*........................ <br /> <br />71 WV~ III ~ PIlIlIlIT OFFICER. <br /> <br />OTRRR <br /> <br />Signature <br /> <br />APPLICAnOR APPROVED BY <br />