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<br />'''-~~_'~--~...,~,~-."...,- <br /> <br />. '-"'C':<''''"~~'''lf;v''-'''''''''''-''~:''',~~f''''l'I''~'l'''~'..'''; ,'_ <br /> <br />APPLICAnON FOR PERHIT <br />CITY OF ZEPIIYRBILLs <br />BUILDING DEPAR'DIENT <br /> <br />OWNER' S NAHE <br /> <br />/ <br />/,--4 r r '--/ <br />/ <br />~?Lj-S- <br /> <br />~' , <br />//7/) /7 <br />~L747-€ <br /> <br />PHONE <br />'Za~.0> !_ c <br />/ <br /> <br />7W ~.2 Lj-1/ <br />AL .-/ ?-t t!-I--Ic_ <br />. /~ /'L.- <br /> <br />0WlIER t S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />c; a~_ <br /> <br />'- <br /> <br />LEGAL DESCRIPTION: LOT(S) / // Lj-O B~SUBDIVISION A-c--d~.t'-: ?-.L/:~_ <br />~ ,. <br /> <br />PARCEL LD.' ~.? .J-S-;:21 ~><A 60~o Ie} ~ (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:~ew Construction --..Addition --Alteration ___epair _Install <br /> <br />_Sign <br /> <br />--Jove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Siogle Faaily <br /> <br />---.Jf./F <br /> <br />_' of Units <br /> <br />---.Jf./H <br /> <br />_eo..ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />~ther5' C'''<-e.p..., ,t-,c'AC- <br />-. '" <br /> <br />Restaurant & Health Departaent Approval <br />DESCRIPTIOII OF WORK: )'C /-.,...e--P/-j /-?o~ <br /> <br />BUILDING SIZE: ) ~ X ?-1, <br /> <br />Square Feet, ? <br /> <br />Height <br /> <br />RESIDENTIAL: <br />cotIMERCIAL : <br /> <br />ATTACH (2) PLOT PLAIIS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW COIISTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />-BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELEcrJlICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />__lEClWlICAL <br /> <br />$ <br /> <br />Valuation of Hecbanical Installation <br /> <br />--PLUHBIIIG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE 9F COIISTIlUCTIOIf: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FDII.SBED PI.OOlt ELEVAnOIlS: <br /> <br />FT. <br /> <br />IS PROJECT III FLOOD ZOO AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BMJ.Da COHPAIIY ALL- A-:n-.pA'/t;4~ ALt:,;.Jr..I/?"; <br />~ . 'II State Cert. or Regist.' )'L t' 0 ~;:26~ <br />. Signature 7~ #- ~~ City License Registration' '7 :.J- <br />** ************************************* <br /> <br />RJ.RCTRICIO <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Si mUll ture <br /> <br />PLIDIBER <br /> <br />COMPARY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />IlECllMlICAJ. <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration f <br />****************************************** <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COMPARY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATXOJI - BY 71/1/V1,!2o G lh n-1.r <br /> <br />PERHIT OFFICER. <br />