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<br />APPLICAnON FOR PERKIT <br />CITY OF ZEPIIDUIILLS <br />BUILDING DEPARTHENT <br /> <br />./.'......'~...""~m".."'~;~.'~'_:.,... __ S--Q~- <br />. '- ~y ~ j, <br /> <br />'..../ <br /> <br />OWNER'S NAHE C A. Ad'( L ~-S S A/''''l F So r-< PHONE L;-~ - '} J-d <f <br />OWIJER'S ADDRESS ~/~....~ CA-/Vl e d C' Ai'; S/;#~ T:./Cf/i/.eL PA R./(, <br />JOB ADDRESS r t q.3 rANI l!" C). '- () -4 1'(' s ~ ~ ~ I~ R /1 . <br /> <br />LEGAL DESCRIPTIOIi: LOT(S) r/~,5 . <br />PARCEL LD.' <br /> <br />BLOClL--SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction ~ition --Alteration -..Jlepair _Install <br /> <br />_Sign <br /> <br />--Jove <br /> <br />---Peaolish <br /> <br />PROPOSED USE: _Siogle Faaily <br /> <br />---.Jf./F _' of Units ---.Jf./H <br /> <br />_eo..ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />Restaurant II: Health Departaent Approval <br /> <br />DESCRIPnOIl OF WORK: / #~7;,-~~ CA~ f'(Jrz..T <br />BUILDING SIZE: 7.3 X 4'a ) <"'7-U Square Feet, <br /> <br />1:1 X 1a: <br />I <br />Jr Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLAIIS II: (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COItMERCIAL: ATTACH (3) SETS OF BUILDING PLANS II: (1) SET ElfERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL HEW COIISTRUCTION. <br /> <br />-AJUILDING <br /> <br />$ <br /> <br />PERMITS REOUESTED <br />I 2- to. a d Valuation of Total Construction <br /> <br />-- ELEcrJlICAL <br /> <br />~ AIIP Service <br /> <br />- Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />~CAL <br />PLUHBIIIG <br /> <br />$ <br /> <br />r---- <br /> <br />Valuation of Hecbanical Installation <br /> <br />..-- GAS <br /> <br />- ROOFING <br /> <br />----- SPECIALTY <br /> <br />TYPE 9F CORSTIlUCTIOIi: _Block _Fraae _Steel <br /> <br />"'t L {j A-1 Other <br /> <br />FIIIISBED 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.DRR <br /> <br />. Signatur- GL l:s<f <br /> <br />. ( <br />COHPANY /-1 f!./LJ7.. <' A '- V N1. <br />/ State Cert. or Regist. . R "X (/ (J ~(/ R / '/, <br />~ ~ " City License Registration I. z-. <br />****************************************** <br /> <br />R'{.RCTRICIO <br /> <br />COMPANY <br />State Cert. or Regist. I. <br />City License Registration , <br />****************************************** <br /> <br />Simullture <br /> <br />PLDNRRR <br /> <br />COMPARY <br />State Cert. or Regist. . <br />City License Registration I. <br />****************************************** <br /> <br />Signature <br /> <br />IlECllMlICAL <br /> <br />COMPAIfY <br />State Cert. or Regist. , <br />City License Registration f <br />****************************************** <br /> <br />Signature <br /> <br />OTRRR r'.... '-"';"',':-:", "> . SI <br />.~._~ <br />, <br /> <br /> <br />COMPANY <br />State Cert. or Regist. I. <br />City Liceqse Registration " <br />*********************-*************** <br /> <br />Signat~e <br /> <br />APPLICATION APPROVED BY <br /> <br />J-ERKIT OFFICER. <br />