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<br />APPLICAnOR FOR PERKIT <br />CITY OF ZEPIIYRIIILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S RAKE <fa1) t W- <br />OWNER'S ADDRESS ~<65Ll ~ KexYLO(o... <br />JOB ADDRESS ~ ?i"-y.-\'lo ~efY'tC)'ro.- <br />LEGAL DESCRIP'l'IOR: LOT(S) BLOCIL-SUBDIVISION~\pe fX./ No.UolO (UHf? <br />/ <br />PARCEL I. D. 1 (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:__ew Construction ~ition bteration ~pair _Install <br /> <br />PHONE }~d-. - ~;:Yb <br /> <br />_Sign <br /> <br />-.JIove <br /> <br />->>eaolish <br /> <br />PROPOSED ~E: _S~e F_i~ <br /> <br />/ <br />----3t/F _' of Units --6/H <br /> <br />_ec:-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />__estaurant &: Health Departaent Approval <br />DESCRIP'l'IOR OF WORK: ~bn J(")hLU {fIe c.ho.{)~ -GU1- <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLARS &: (2) SETS OF BUILDING PLARS &: (1) SET ENERGY FORKS. <br />COMKERCIAL: ATTACH (3) SETS OF BUILDING PLARS &: (1) SET ERERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CORSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />RT.R.crRICAL <br />hawnCAL <br /> <br />AHP Service Florida Power Corp. <br />$ J (QQC:) . c.t:::) Valuation of lIecbanica1 Installation <br /> <br />W.R.E.C. <br /> <br />--.-..J'LUMBIaG GAS ROOFIRG <br />TYPE 9F mBSTRUCTIOR: .-Block _Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FDI.SIIED FlOOR ELEVAfiOBS: <br /> <br />FT. <br /> <br />IS PROJECT IR FLOOD ZORE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />BIITl.DRR <br /> <br />cotIPANY <br />State Cert. or Regist. 1 <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />RT.R.CTlUCIAII <br /> <br />COMPANY <br />State Cert. or Regist. 1 <br />City License Registration 1 <br />****************************************** <br /> <br />Signature <br /> <br />PLUKBER. <br /> <br />COMPANY <br />State Cert. or Regist. 1 <br />City License Registration 1 <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL COMPANY / <br />p/ >h :It ~,hJ State Cert. or Regis . · <br />Signature (, ~ Of'. 0'Yl City License Registration' <br />***************************************** <br /> <br /> <br />OTHRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />****************************************** <br /> <br />APPLICAnOB APPROVED BY PERKIT OFFICER. <br />