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<br />,";', "'''',,''- ""'~-7 <br /> <br />APPLICAnON FOR PERHIT <br />CITY OF ZEPBYRBILLs <br />BUILDING DEPAR'DIENT <br /> <br />, I~ f <br />_'S - ~~ ~et <br />OWlIER'S ADD~ 7 ~/rJl <br />JOB ADDRESS ~ & '- <br /> <br />PHONE a=t 3 - 7 rz - 5d-t 3 <br /> <br />LEGAL DESCRIPTIOIf: LOT(S) <br />PARCEL I. D.' <br /> <br />BLOClL..-SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction --..Addition --Alteration ---.Jlepair ~Insta1l <br />_Sign --Jove --Peaolish <br />PROPOSED USE: _Siogle Faaily ---.Jf./F _' of Units ---.Jf./H <br />.J:Leo..ercial _Indust. _Swia. Pool _Other <br /> <br />___estaurant & Health Departaent Approval <br /> <br />DBSCIlIPITOII OF -~~/I 1&~:,,~.,t1 h~e .1jA ~M ~ <br />{J <br />BUILDING SIZE: X ~uare Feet, Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLAIIS & (2) SETS OF BUILDIIIG PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />RJ.RcrJlICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />__lEClWlICAL <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />--PLUHBIIIG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE 9F COIISTIlucnOIf: _B1ock _Fraae _Steel <br /> <br />Other <br /> <br />PDIISIIED FLOOll ELEVAnOIlS: <br /> <br />FT. <br /> <br />IS PROJECT IIi FLOOD ZOO AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BIIl:J.Da <br /> <br />COHPAIIY <br />State Cert. or Regist. , <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />RJ.RCTRICIO <br /> <br />COHPARY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />SiDnAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />IlECllMlICAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration f <br />****************************************** <br /> <br />Signature <br /> <br />OTRRR k COMPANY ~~~A.... ~t~~ )KA P/~A-4 <br />I /.. t7 State Cert. or:Regist. . <br />Signature /d~ City License Registration t '7 f? / <br />~ ****************************************** <br /> <br />APPLICAnON APPROVED BY <br /> <br />PERKIT OFFICER. <br />