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<br />.- "C"--'~.p''''''''I..''''''''-'',-'''''<:r''''."'''''~''.'l''''''-:''''';.r"''''''''''' <br /> <br />APPLICAnOIf FOR PElUlIT <br />CITY OF ZEPBYRBILLs <br />BUILDING DEPAR'DIENT <br /> <br />OIIIIBIl'S IWlIl It p ~ E?:. <br />0WlIER' S ADDUSS _<: / ~ J <br />~~V <br /> <br />G/jt/~ T <br />7/?~ <br /> <br />PHOIfE ~yy S/?c2 <br /> <br />JOB ADDRESS <br /> <br />'- <br /> <br />LEGAL DESCRIPTIOIf: LOT(S) <br /> <br />BLOCIL.-.-SUBDIVISION <br /> <br />PARCEL LD.' Jt/ 4 (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:-"ew Construction ----Addition --Alteration ---.Jlepair~Atall <br /> <br />_Sign <br /> <br />--Jove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: ~iog1e Faaily <br /> <br />---.Jf./F _' of Units ---.Jf./H <br /> <br />_eo..ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />-At ~t Awrova1 <br />DESCRIPTIOII OF WORK: . <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />, / g C/O Square Feet, <br />, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLAIIS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL IfEW COIISTRUCTION. <br /> <br />-BUILDING <br /> <br />oV <br />$ (2~OV <br /> <br />PERMITS REQUESTED <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 />__lIEClWlICAL <br /> <br />$ <br /> <br />Valuation of Hecbanical Installation <br /> <br />_PLUMBIIIG <br /> <br />GAS <br /> <br />~ooFING <br /> <br />SPECIALTY <br /> <br />TYPE 9F COIIST.RDCTIOII: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FDIISIIED PLOO1l ELEVAnOIlS: <br /> <br />Fl. <br /> <br />IS PROJECT III FLOOD ZOO AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />. mRrRACmR ~~ <br />RlIDJ>RR ~ lXIIPARY ~tMO ~ l>.e/(J~~s <br /> <br />State Cert. or Regist.' CC 6 CJ S- / ~ ~ / <br />Signature . . City License Registration . <br />~ **** ************************************ <br /> <br />RJ.RCTRl;CIO COMPANY <br />State Cert. or Regist. . <br />SiDnAture City License Registration' <br />****************************************** <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />****************************************** <br /> <br />IlECllMlICAL COHPARY <br />State Cert. or Regist. . <br />Signature City License Registration f <br />****************************************** <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration , <br />****************************************** <br /> <br />APPLICAnON APPROVED BY PElUlIT OFFICER. <br />