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<br />APPLICATION FOR PERfIIT <br />CITY OF ZEPBYRB.ILLS <br />BUILDING DEPARTKERT <br /> <br />OWNER'S RAKE ~y !/I//ft:ie M/)/LOel?5 <br />OWNER'S ADDRBSS/9~601 B'k!Jllr P p, llJ{AJAK. Blv'IJ <br />JOB ADDRBSS.t<;t 3Cf ~fl14 fJ/f;A t .?fj <br /> <br />PHONE <br /> <br />7stj-/~d <br /> <br />LEGAL DESCRIP'l'ION: LOT(S) <br /> <br />.gy <br /> <br />BLOCK <br /> <br />SUBDIVISION S/L. (/ e 12 <br /> <br />O/l~ <br /> <br />PARCEL LD.' ~-d6-r;J.1 - all:'(5 -n{Y)tJo - Qy,;O (OBTAIN FROM PROPEaTY TAX NOTICE) <br />WORK PROPOSED: XNew Construction -----Addition ---...Alteration ~epair _Install <br /> <br />_Sign <br /> <br />----.JIove <br /> <br />--Peaolish <br /> <br />PROPOSED USE: ~s~eF_i~ <br /> <br />----.JI/F _' of Units ----If./H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />~estaurant &: Health Departaent Approval <br />DESCRIPTION OF WORK: ~:.;/)))~ Le t::;r.; /Vl / ~ I? e ~ <br />I <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />f~i Pi.A ~ <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL .NEW CONSTRU~ION. <br /> <br />PERKITS REOUESTED <br /> <br />RT.RCTRICAL <br /> <br />$ h~OOO Valuation of Total Construction ,. <br />ISQ AIIP Service X Florida Power Corp. W.R,E.C. <br />$ p., 9 06 Valuation of lIecbanical Installation <br /> <br />~UILDING <br /> <br />---1IECllANICAL <br /> <br />~mmIRG <br /> <br />GAS <br />)( Block <br /> <br />~Jv.rI:Jle ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF COBSTRUcnOR: <br /> <br />_Fr_e _Steel <br /> <br />\ Other <br /> <br />FIRlSBED FLOOR ELEVAnOBS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />A <br />YES NO <br /> <br />*......................................... <br /> <br />CONTRACTOR SECTION' <br /> <br />.... <br /> <br />RIJIT.DER <br />Signature MJ..kI.j a <br /> <br />COKPANY -t. <br />~ State Cert. r llegist. <br />City License Registration , <br />. ,..................................... <br /> <br />. v COMPANY J I- l' E /~c.. r- ~ he- <br />State Cert. or Regist.' Efl. c;ro-o 2. 0 '1S- <br />~-QtA' . City License Registration.' '2 Y.f- <br />........................................ . <br /> <br /> <br />RT .RCTRICIAli <br />SiQlUlture -a---~ d. <br />,/ <br /> <br />PLUMBER COMPANY <br />1j. j ~ State Cert. <br />Signature }f )~~ City License Registration , <br />.......................................... <br /> <br />tlECBANICAL ~J ~ ~ANY~-Aec--A~ Co - <br /> <br />~ State Cert. or Regist. , CACa~l/.c.J-J <br />Signature~. City License Registration f /5/ <br />........................*................. <br /> <br /> <br />" <br /> <br />OTIIRR COMPANY <br />State Cert. or Regist, . <br />Signature City License Registration , <br />.......................................... <br /> <br />APPLlCAfiOX APPIlIMlD BY -1/ tiVYV'1J ,171 ~~ PBRIIIT OFFICER. <br />