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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPBYRBlLLS <br />BUILDING DEPARTKENT <br /> <br />OWNER' S IWtB nor 1'1.. A <br />OWNER' S ADDRESS o7J , '-/ <br />JOB ADDRESS -6 f!t / Y <br /> <br />J C) h N5o/v <br /> <br />~~ <br />~~/ I <br /> <br />BLOCIL--SUBDIVISION 7.A';'.t( p'_'~ v~~ <br /> <br />PHONE <br /> <br />79~~ 3 ~ Y <br /> <br />LEGAL DESCRlP'llON: LOT(S) <br /> <br />PARCEL I. D. t (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED: ~w Construction ---Addition ~teration ---..Repair _Install <br /> <br />_Sign <br /> <br />---1Iove <br /> <br />->>eaolish <br /> <br />PROPOSED~E: ___S~eF_i~ <br /> <br />---1I/F _' of Units ---1I/H <br /> <br />___ec-ercial <br /> <br />___Indust. _Swia. Pool _Other <br /> <br />DESCRIPTION OF WORK: <br /> <br />---..Restaurant &: Health Departaent Approval <br />ZSA~. <br /> <br />~ <br /> <br />~ <br /> <br />~ <br /> <br /><r~ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RE5IDEI1TIAL: <br />COHKERCIAL : <br /> <br />ATTACH (2) PLOT PLARS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUlLDIBG PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />~UlLDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />RI.RCTRICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---..JIECBAlIICAL <br />.--PLutmDG <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE ~F: <:OBSTRUCTION: ___Block ___Fraae _Steel <br /> <br />Other <br /> <br />FIllISHED FLOOR ELEVAnONS: <br /> <br />Fr. <br /> <br />IS PROJEct IN FLOOD ZONE A1lEA7 <br /> <br />YES . NO <br /> <br />.......................................... <br /> <br />Rml.DER ~ <br />Sigoature ~ <br /> <br />fJ~ <br /> <br />COIITRACTOR r;,rcnZ1 .' . <br /> <br />lmPAIIY ~,f~ ~ <br />State Cert. or Regist. . 13 e.. 0/ j/ ~ ~ <br />City License Registration . 3 ~~ <br />.......................................... <br /> <br />RT.RCTRTClAB <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration f <br />.......................................... <br /> <br />Siooature <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />IlECIIAliICAL <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Sigoature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERHIT OFFICER. <br />