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<br />APPLICAnON FOR PERKIT <br />CITY OF ZEPRYRBIu.5 <br />BUILDING DEPARTMENT <br /> <br />_'S_ ~ ~.\ \(oD~ ~u((~t:fs.wllll l~a- - ~~dS <br />OWNER'S ADDRESS f) ~\ hen~ ~m <br />JOB ADDRESS 1o~40 ~e ~~ ~ <br />LEGAL DESCRIP'I'ION: LOT(S) aJ BLOCK SUBDIVISION <br />PARCEL LD.' " - Q(P - Q..J -Q/1eD -cccaJ-- D0CO (OBTAIN FROK PROPERTY TAX NOTICE) <br />WORK PROPOSED: hw Construction ~ition ----..Alteration __epair _Install <br /> <br /> <br />_Sign <br /> <br />-.JIove <br /> <br />->>eaolish <br /> <br />PROPOSED~E: ~~eF_i~ <br /> <br />----3t/F _' of Units _K/H <br /> <br />_ec:-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />--Restaurant. Health ~ Approvsl () <br /> <br />DESCRIP'l'IOR OF WORK: \ La X;;() ~ Qf} ''-DOrm <br /> <br />BUILDING SIZE: llo X c.X:), 3'd.O ~uare Feet, Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PI..ARS &: (2) SETS OF BUILDIRG PLANS &: (1) SET ERERGY FORMS. <br />COHHERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ERERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CORSTRUCTION. <br /> <br />~UILDING <br /> <br />$ <br /> <br />\ 't()O~ <br /> <br />PERKITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />----KECllAllICAL <br /> <br />$ <br /> <br />Valuation of lIecbanical Installation <br /> <br />.-PLUIIBDG GAS ROOFIRG <br /> <br />SPECIALTY <br /> <br />TYPE OF OORSTIlUC'rIOR: -Dloclt _Fraae _Steel <br /> <br />Other <br /> <br />FDlISBBD FLOOR. ELEVAnORS: <br /> <br />Fl. <br /> <br />IS PROJECT IN FLOOD ZOO AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />BIITT.DER <br /> <br />fIf . COIiTJIA=":1~(d ~n-trL~C2bk <br /> <br />State Cert. or Regist. . <br />City License Registration . ~~ <br />, .......................................... <br /> <br />Signature <br /> <br />IU.RCTRICIAR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />SiQllature <br /> <br />PLOKBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />KECHARICAL <br /> <br />Signature <br /> <br />COKPANY <br />State Cert. or Regist. f <br />City License Registration . <br />.......................................... <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />APPLICAnOB APPIlOVJlII BY ~'~ Yh ~i~ <br /> <br />PERKIT OFFICER. <br />