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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPIIYRBILLS <br />BUILDING DEPARTHENT <br /> <br />!, <br /> <br />1J1" ?-f JeI- <br />50' <br /> <br />./ <br />. A. PJS <br />4,-J <br /> <br />; ,- it (< U. ~ <br />OWNER'S NAHE g~ ~ V //1 4Qp . U1) )e r;5 PHONE <br />_'S AIHlIIP& .. /:A~V ~~~p . 12 DOWrh <br />JOB ADDRESS 5/, = f' tf'1,:l'1 . " <br />LEGAL DESCRIFrION: LOT(S) ~ I BLOCK SUBDIVISION S/l:".veR 64.;::5; <br />PARCEL I.D.' 3-:;;b - d, / - 0 /60 ~ noeXM -~o (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />C1Q / _I:) ~?~ <br />flU D --;A m Pll <br /> <br />WORK PROPOSED : hew Construction ~ddition --.J\1teration ---..Repair _Install <br /> _Sign ---1Iove ->>eaolish <br />PROPOSED USE: )< SiDgle Faai17 ---1I/F _' of Units ---If/H <br /> _ec-ercial _Indust. _Swia. Pool _Other <br /> <br />---Restaurant &: Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: ..-.:{//'IQU <br />v <br /> <br />j:::'J9M/Lv' <br />I <br /> <br />Rr~' <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FOlUlS. <br />COtIKERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />RT.Rcr.RICAL <br /> <br />$ )~.ooo <br />/50 AtIP Service <br /> <br />Valuation of Total Construction <br />)< Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />~UILDING <br /> <br />---1IECBANICAL <br /> <br />$ ~300 <br /> <br />Valuation of Mechanical Installation <br /> <br />-PLUKBING GAS ~,r- ROOFING <br />TYPE OF CORSTRUcnON: ..2:S:..s1ock. _Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FIllISBED FLOOR ELEVATIORS: <br /> <br />Fr. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />L <br />YES NO <br /> <br />..........................******.*.*.***** <br /> <br />CONTRACTOR SECTION' <br /> <br />mHPANY ~~ql;O~ ~A.~~~ <br />-#)!l -+ /1) J~ State Cert. or Regis . (' C; c.~t;fJo <br />Signature ~~ u...",Kp City License Registration '.__ <br />** ****.....*...*........*.*....*........ <br /> <br />COMPANY 5 rI- 5" E I tc'cr ~ J;, c... <br />~ State Cert. or Regist. . ell. ~ 2..() (lj- <br />-q /.2...... City License Registration'. 2 V j - <br />.***.***.***.*.**.******....************* <br /> <br />PLUMBER COMPANY ,/j'dA/n1..tin ~ .~:<~ <br />/.,1 ) /JJ '7 / jl State Cert. or Regist. f.~' / / <br />Sigoature//Z/ L( << :/ ~ City License Registration i ./ ~/ <br />..**.*.***.********.********************** <br /> <br />BIJJI.DO <br /> <br />RT.RCTRICIAH <br />SilmAture WA4d;"'/ a <br />v <br /> <br />IlEGBANIGAL <br />Signature d.' ,;}0f.~~ <br /> <br />COMPANY A. f _ C III (J (- ()/\,//) <br />State Cert. or Regist. . CA~ 0 12W') <br />City License Registration . J..s"/ <br />*..**.****....*....****...**.*.*..*....... <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />..**.*..**....***.********..***.********** <br /> <br />Signature <br /> <br />APPLICAnOR APPJlOVIlD BY J? M~ !J? #ff~rJ <br /> <br />PERMIT OFFICER. <br />