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<br />APPLICATION FOR PERHlT <br />CITY OF ZEPIIYlUIILLS <br />BUILDING DEPARTHERT <br /> <br />.'1 <br />.. 'Il .' ~ <br />f1( f - 1/'3-76 . <br /> <br />..... <br />A-- J,/D <br />'1 c~ <br /><-= '.....j. r\' b-b <br />7'-7 - /~: . <br />t6'L(/ j) <br /> <br />01lIIEIi' s IWIB !J J:t Y (// 1/11 C,co & / L/J:': l? S PIIOII.Il <br />OWER'S ADD~S /9b'S 0 / ai( Ulcf~ 12 ()ONNS <br /> <br />, ., <br /> <br />JOB ADDRESS~ ifLj .J;f;..N-0M ~Q~/ t.-:J 7.:{:L <br />LEGAL DESCRIPTION: LOT(S) if t.f BLOCK SUBDIVISION S/Lc/e I? (5,4;(j; <br />PARCEL LD.' 3 -db -;)/ - nlf-,n -OOC-CO -O'3CJO (OBTAIN FRON PROPERTY TAX NOTICE) <br />WORK PROPOSED: )(New Construction ~ddition ~teration -.Jtepair _Insta1l <br /> <br />_Sign <br /> <br />----1fove <br /> <br />--Peaolish <br /> <br />PROPOSED USE: XsiDgle FaaUy <br /> <br />--1.t/F _, of Units --1.t/B <br /> <br />_ec:-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />/ <br /> <br />DESCRIPTION OF WORK: :5) .All? Le <br /> <br />-.Jtestaurant Ii: Hea1th Departaent Approval <br /> <br />;C4m/l; Re( <br />! <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDERTIAL: AT'lACB (2) PLOT PLANS Ii: (2) SETS OF BUILDING PLANS Ii: (1) SBT ENERGY FORMS. <br />COMMERCIAL: AT'lACB (3) SETS OF BUILDING PLANS Ii: (1) SET BNERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />RT .RcrRI.CAL <br /> <br />PERKITS REOUESTED <br />$ (~. 00 0 Valuation of Total Construction <br />/5() AIIP Service X Florida Power Corp. <br /> <br />.\ <br /> <br />.-BUILDING <br /> <br />W.R.B.C. <br /> <br />--1IECIIARlCAL <br /> <br />$ !).760 <br /> <br />Valuation of Mechanical Installation <br /> <br />--YLUKBIRG GAS Sj//Ntf t..e ROOFING <br />TYPB OP COBSTRUcnON: -.K.alock _Praae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FI1IISHED FLOOR ELEVAnOBS: <br /> <br />FT. <br /> <br />IS PROJECl IN FLOOD ZONB AREA? X <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION' <br />) <br /> <br /> <br />Signature <br /> <br />'f?~ <br /> <br />COKPABY <br />~. [ State Cert or Regis . .. <br />Q Y City License Registration , <br />... ...................................... <br /> <br />RIJTI.DER <br /> <br />RT .RcrRI.CIAR COMPANY S";'5 E IT!" c,I- C" ...;:: "t/ c. <br />07 1 4' ~ ?.A State Cert. or Regist. .. c=/?.~ 2..0 ,/.$- <br />SiDnSlture,V~~/~. ~./L . City License Registration', Z v.S- <br />~ .......................................... <br /> <br />Signature <br /> <br />COMPANY -f ~YL -t/-'~7~ <br />/./.t-~ .--? I / , State Cert. or Regist.' t:fP~::U):S~ G./ I <br />?/(/(.L..J(:::;./~ City License Registration . / d" <e/ <br />.......................................... ' <br /> <br />PLUMBER <br /> <br />HECllANICAL / <br />Signature //-JJ. #~wAd <br /> <br />COMPANY A. t. C A/t ct.rlJlJ <br />State Cert. or Regist. .. Ac 361<7q7 <br />City License Registration . /S'Y <br />.......................................... <br /> <br />COMPANY <br />State Cert. or Regist. .. <br />City License Registration , <br />.......................................... <br /> <br />OTRRR <br /> <br />Signature <br /> <br />APPLICAUOB APPIIOVBD BY .71 ilAlJ'7J 111 ~~1 <br /> <br />PERKIT OFFICER. <br />