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<br />-~~..-.-,~".~"-".",,. <br /> <br />APPLICAnON FOR PElUlIT <br />CITY OF ZEPIIYlUIILLS <br />BUILDING DEPAR'l'HENT <br /> <br />OWUR'S NAIfE%.ePHye;/lU s 3P~N' 4JM'€L &>. <br /> <br />PHONE S'I S. '7 '13 - 19 $"9 <br /> <br />OWI1ER'S ADDBESS ~YSo :)..0"'''' s..,..eu,- <br /> <br />:z./E PAl t" R J.I 1I.l..5 , L <br />. <br /> <br />3'3S".yb <br /> <br />JOB ADDRESS YS30 <br /> <br />.:;J.D .,..,<1 .$ .,..~.,.. <br /> <br />~EPH-r-It.{.JIU$ .;:t... :s 3 No <br /> <br />LEGAL DESCRIP'lION: LOT(S) <br /> <br />:BLOCIL--.SUBDIVISION <br /> <br />PARCEL LD.' <br /> <br />(OBTAI. FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction ---^<<Idition -----.Alteration ~pair _Install <br /> <br />_Sign <br /> <br />.-JIove <br /> <br />->>eaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />----Jf/F _' of Units ----Jf/H <br /> <br />_ec:-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />___...'Restaurant &: Health Departaent Approval <br /> <br />DESCRIPTIOII OF WORK: <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />, <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDEIITIAL: <br />COMMERCIAL : <br /> <br />A'l'TACB (2) PLOT PLABS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />ATlACII (3) SETS OF BUILDING PLANS &: (1) SET EIIERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW COIISTRUCTION. <br /> <br />PElUlITS REOUESTED <br /> <br />~UILDING <br />V RT.RCl'RICAL <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />~CAL <br /> <br />$ <br /> <br />Valuation of Kechanica1 Installation <br /> <br />_PLumING GAS ROOFIIIG <br />TYPE 9F COIIS'l'JWCTIOII: -.-..JUocIt _Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />PIIIISJIED FLOOK ELEVAnOIlS: <br /> <br />Fl. <br /> <br />IS PBOJECT IN FLOOD ZOO AREA? <br /> <br />YES NO <br /> <br />................................***.*.***. <br /> <br />CONTRACTOR SECTION <br /> <br />mHPAIIY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />. COMPARY /~~~ 4. <br />~~ State Cert. or Regist.' 6)0 3~1.s <br />~ . City License Registration' ~ 300 <br />......................................... <br /> <br />RIITTDRR <br /> <br />,Signature <br /> <br />RT .Rr.TRTCIAIl <br /> <br />Signature B'7d <br /> <br />Signature <br /> <br />COKPARY <br />State Cert. or Regist. f <br />"... City License Registration f <br />.......................................... <br /> <br />PIDlBER. <br /> <br />COKPARY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................*.. <br /> <br />HECBAIIICA.T. <br /> <br />Signature <br /> <br />COMPARY <br />State Cert. or Regist. . <br />City License Registration . <br />.............*............................ <br /> <br />OTRRR <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PElUlIT OFFICER. <br />