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<br />APPLlCAnON FOR PERMIT <br />CITY OF ZEPIIYRIIILLS <br />BUILDING DEPARTKERT <br /> <br />OWNER'S lWIE ( )e~\.{ l~~ Kn.JCP\, f-1eJ \:n PHONE --r8~--)<3yqO <br />OWER'S ADDUSS (~~d ~~Ur. U{)~/,"",~\\~ \J~l. 3~f) <br />8nJY\v <br />LEGAL DESCRIPTION: LOT(S) (0 B~SUBDIVISION <br />PARCEL LD.t V J ~ -:2.6 - 02/ - 0 D36 - ~ 0 YD 0 - 666 D (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:__ew Construction ~ition ---Alteration --Repair ~nAtall <br /> <br />JOB ADDRESS <br /> <br />_Sign <br /> <br /> <br />PROPOSED USE: V-:i.ng1e Faaily <br /> <br />--1I<>ve <br /> <br />_De-.olish <br /> <br />----1f/F _' of Units ----1f/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />-..Restaurant Ii: Hea1th Departaent Approval <br />DESCRIPTION OF WORK:_H'\.S ~\ \/ C<s(\ ltc'\ \ ~ 0{ 0\ If . Co l'"\Cll T() f\ 1 ~ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />. 1100 <br />" <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDERTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLARS Ii: (2) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL HEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />.-BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />RT.RCTlUCAL <br />~awnCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />I L'") <)<) ~o 0 <br /> <br />Valuation of llecbanical Installation <br /> <br />----..PLUMBDiG <br /> <br />GAS <br /> <br />ROOFIRG <br /> <br />SPECIALTY <br /> <br />TYPE 9F OORS'l'RUCl10N: _Block <br /> <br />_FraIIe _Steel <br /> <br />Other <br /> <br />F1IIISBED PLOOll ELEVAnOIlS: rr . <br /> <br />IS PBOJEC'l IN FLOOD ZONE AREA' <br /> <br />~ <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />BIITIDRR <br /> <br />Signature <br /> <br />Rl-llOD1Wll <mPAIIY \j~( ~;(." ~ D~ <br />~ ~ ~ State Cert. or Hi 1st. f. C)\\C,j <br />SiirnAtur ~ City License Registration , ') "1 ") <br />.......................................... <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration . <br />.......................................... <br /> <br />PLUMBER <br /> <br />IlECllARICAL <br />Signature ~~ <br /> <br />~ <mPAIIY <br />State Cert. or Regist. , <br />7 City License Registration . <br />.......................................... <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration , <br />.......................................... <br /> <br />IlTRRR <br /> <br />Signature <br /> <br />APPLICATIOll APPIIOVED BY /7CUth;J ()J ~~ <br /> <br />PERHIT OFFICER. <br />