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<br />APPLICAnON FOR PERMIT <br />CITY OF ZEPIIYRIIILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S <br /> <br /> <br />HONE 7 tjJ - 3701 <br />k'1-#-~ <br /> <br />OWRER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCIL...-.SUBDIVISION <br /> <br />PARCEL I. D. t (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED: ~W Construction ----.Addition ---Alteration ---:Repair _Install <br /> <br />_Sign <br /> <br /> <br />PROPOSED USE: ~iDgle Faaily <br /> <br />-.JIove <br /> <br />_Deaolish <br /> <br />--Jt/F <br /> <br />_' of Units --Jt/B <br /> <br />_~ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />DESCRIPTION OF WORK: <br /> <br /> <br />rJ / (, Square Feet, <br /> <br />BUILDING SIZE: <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS rr (2) SETS OF BUILDING PLANS rr (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS rr (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~IRG <br /> <br />$ <br /> <br />115V~ <br /> <br />PERMITS REQUESTED <br /> <br />Valuation of Total Construction <br /> <br />_ELEenuCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---1IECllAlJICAL <br /> <br />$ <br /> <br />Valuation of Ilechanica1 Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUC'I'ION: _Block _FraIIe _Steel <br /> <br />Other <br /> <br />FIIfISBED FLOOR ELEVAnONS: <br /> <br />FT. <br /> <br />IS PROJEcr IN FLOOD ZONE AREA? <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />RIJTT.DER COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration . <br />.............................. <br /> <br /> <br /> <br />RI.RCTRTCIAIl COMPANY <br />State Cert. or Regist. . <br />SignAture City License Registration . <br />.......................................... <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration . <br />.......................................... <br /> <br />IlEClWflCAL COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration . <br />.......................................... <br /> <br />OTIIRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />APPLICAnON APPROVED BY PERMIT OFFICER. <br />