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<br />"""",,;:,"""-''''I''',"":,~'r.''f''''''--~'''' <br /> <br />APPLICAnON FOR PEBIIIT <br />CITY OF zEPIIDBILLS <br />BUILDING DEPARTHENT <br /> <br />JOB ADDRESS <br /> <br />I~~ G~"S~fl- <br />S2f?:;"\ \=o~""\ \-~~ <br />~~ <br /> <br />PHONE <br /> <br />SCc. f- <:0 S ~'-~ <br /> <br />OWNER'S IIAHR <br /> <br />~ <br /> <br />OWREB.' S ADDBESS <br /> <br />...... <br /> <br />LEGAL DESClUP'fiOR: LOT(S) <br /> <br />BI.OCK..--SUBDIVISIOR <br /> <br />PARCEL I.D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew construction ~ition ~teration ~pair _Install <br />_Sign ~ve ~lish <br />PROPOSED USE: _Single F8IIily ----31/F _' of Units ----31/H <br />_ec-ercial _Indust. _Swia. Pool ~o~er <br /> <br />DESCRIPTIOII OF WORK: <br /> <br />. .--Jlestaurant Ii: Health Departaent Approval <br /> <br />~~~~ <br /> <br />BUILDDG SIZE: <br /> <br />x <br /> <br />square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COHKERCIAL : <br /> <br />ATTACH (2) PLOT PLAlIS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATtACH (3) SETS OF BUILDING pLANS Ii: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW COIISTRUCTION. <br /> <br />pF.RMITS REO~TED <br /> <br />~UILDING <br /> <br />$ <br /> <br />valuation of Total Construction <br /> <br />RJ.RCTRI.CAL <br /> <br />AHP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_PL1IIBING <br /> <br />GAS <br /> <br />Valuation of Hechanical Installation <br />y. ROOFING SPECIALTY <br />_Fraae _Steel Other <br /> <br />.___JIECllAllICAL <br /> <br />$ <br /> <br />TYPE 9F OOlISTIlUCTIOIi: ~lock <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZOO AREA? <br /> <br />FIJDSBED FLOOIl BLEVAnOIlS: <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />coHTRACTOR SRCTION <br /> <br />,., <br /> <br />PUJMBER. COMPAIfY <br />State Cert. or Regist. , <br />Signature City License Registration · <br />****.************************************* <br /> <br /> <br /> <br />BIlTl.DU COMPAIfY <br />State Cert. or Regist. . <br />Signature City License Registration , <br />****************************************** <br /> <br />RJ_RCTRTCIAII COHPAIfY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />JlRCRAlfICAL COHPAIfY <br />State Cert. or Regist. . <br />Signature City License Registration f / <br />****************************************** <br /> <br />IU"E" CCIIPAIIY &I-\~ ~~\...(,. <br />State Cert. or Regist.' [l <- cosec "llD3 <br />Signature City License Registration' 42- <br />********************************* <br /> <br />