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<br />.,.".. "~"-' ('{"r"~'~"-.ilJ""'" """"'lI""""':"'I1",<;~~C'-' 'C~''''',-',:~,.O':. <br /> <br />APPLICAnOR FOR PERKIT <br />CITY OF ZEPIMUIILLS <br />BUILDING DEPAR'l'HERT <br /> <br />OWRER t S IIAHE <br />OWIIER. t S ADDBESS (y' 1'..t ...{-- <br /> <br />II P. ?l 1-14 C J I~ Gu / f iJ 1-1 J --f' ,INC PHONE 7~ tJ - /..:~ ?.:S <br />. <br /> <br />0- e cI~ IC: Ie i ~ d p P [) Ii"- .z -G t> ;: -/ J::' 4 , . /4- / I:: / J~' ...r-.yv <br />, ,. . <br /> <br />6 7 d. f- r f! 01. -c ~. -tic c:' b p. _ Z t' ~ .( '/ ~ ~ . . ./4- F ~ -..r ~ J "9'0 <br />/ , <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIP'l'IOR: LOT(S) B~SUBDIVISIOR <br />PARCEL I. D. 1 d - d 6 - J 1 ~ {!J tJ cl CJ - (!) t!J / ~ CJ - C! t!J IS 0 (OBTAIR FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction ~ition ~teration --..Jl.epair _Install <br />_Sign -.JIove ->>eaolish <br />PROPOSED USE: _S~e F_i~ ----3t/F _' of Units ----3t/H <br />~rcia1 _Iodust. _Swia. Pool _Other <br /> <br />__estaurant Ii: Health Departaent Approval <br /> <br />DESCRIP'l'IOR OF WORK: <br /> <br />THIf:~I-~~ <br /> <br />/2 e t '1-"1 0 dt-' <br /> <br />/,',...., r.;:. <br />" <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDBIlTIAL: ATtACH (2) PLOT PLUS Ii: (2) SETS OF BUILDING PLARS Ii: (1) SET EHERGY FORKS. <br />COMKERCIAL: ATTACH (3) SETS OF BUILDING PLARS Ii: (1) SET EHERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL HEW CORSTRUCTION. <br /> <br />PERKITS REQUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />~ cP S-. & D <br /> <br />Valuation of Total Construction <br /> <br />RT.RcrJUCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-"ECBAIIICAL <br />-PLOIBIXG <br /> <br />$ <br /> <br />Valuation of llecbanica1 Installation <br /> <br />GAS <br /> <br />ROOFIRG <br /> <br />SPECIALTY <br /> <br />TYPE 9F COItS'l'R.UCrIOR: ----..Block _Fraae _Steel <br /> <br />Other <br /> <br />PIIIISIIBD PJ.OOB. ELEVAnoRS: <br /> <br />FT. <br /> <br />IS PRO.JEcr IX FLOOD ZOO AREA? <br /> <br />YES NO <br /> <br />***...*............*....**..*............. <br /> <br />CONTRACTOR SECTION <br /> <br />COIIPAIIY To it ~I .. L, S:',-,- . . j- /1- {! d ", S ~. <br />. ~te Cert. or Regist. 1 /2' L~ .. f 7_';'.L / <br />-~ity License Registration 1 6.s- <br />.........................**............... <br /> <br />:=~, " . COIIPAIIY ~~,t? {~'"",::o 4C L FL h?^K,c/Lr' ",<JT, <br />/ ~~ ~ State Cert. or Regist. 1 <br />? ~...." City License Registration 1 ~ ~y . <br />...**......*........*..................... <br /> <br />RIff' .DO <br /> <br /> <br />~ <br /> <br /> <br />Signature <br /> <br />PLtJIIBER. COKPAIIY <br />State Cert. or Regist. 1 <br />Signature City License Registration 1 <br />*.*...*.*.*............................... <br /> <br />KECllARICAL COIIPAIIY <br />State Cert. or Regist. 1 <br />Sigoature City License Registration . <br />*..*.....*.*...*....*..**...*.*........... <br /> <br />OTRRR COHPAIIY <br />State Cert. or Regist. 1 <br />Signature City License Registration . <br />.....................*.................... <br /> <br />APPLICAnOB APPROVED BY PERMIT OFFICER. <br />