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<br />APPLICAnON FOR PERIIIT <br />CITY OF ZEPIIYRIIILLS <br />BUILDING DEPAaTHERT <br /> <br />OWNER'S lWIB c: Hu r~h V-P (;<5 d <br />OWNER'S ADDDSS '- ~ c::; 'I <f{J ~ II. C! 0 I'n. A V ~ . <br />JOB ADDRESS S~nt ~ d-s 1+ b 0 \J 'E:... <br /> <br />PHONE <br /> <br />LEGAL DESClUP'l'ION: LOT(S) <br /> <br />B~SUBDIVISION <br /> <br />PAaCEL LD.# <br /> <br />(OBTAIN FROM. PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew CQnstruction --.-.Addition ---J\lteration --Repair _Install <br /> <br />_Sign <br /> <br />--.-JIove <br /> <br />_Deaolish <br /> <br />PROPOSED WE: _S~eF_i~ <br /> <br />--.Jt/F _' of Units --.Jt/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />---..Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RlmIDEBTIAL: <br />COMMERCIAL : <br /> <br />ATtACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET DOGY FORMS. <br />ATTAaI (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~UILDING <br /> <br />PERMITS REQUESTED <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />RT.RcnuCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />H.R.E.C. <br /> <br />-"ECIWIlCAL <br /> <br />$ <br /> <br />Valuation of llechanica1lnstallation <br /> <br />---.-.PLutmIllG <br /> <br />GAS <br /> <br />ROOPIRG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUGnON: _______loclt _Fr_e _Steel <br /> <br />Other <br /> <br />PDJISBED FLOOJl ELEVAnOIlS: <br /> <br />Fl. <br /> <br />IS PROJECT III FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.........................................* <br /> <br />CONTRACTOR SECTION. <br /> <br />RIITT.QER aJHPANY <br />State Cert. or Resist. # <br />Signature City License Resistration . <br />*..**...........*.................*....... <br /> <br />RT.RCTRTCIAR COMPANY <br />State Cert. or Resist.' F <br />SianAture City License Registration' <br />...............*...........~....**.**.....p /;/ <br /><:.. 0 f'(J:!d.. ..LS( e (00 ~.. , <br />PLUKBER COKPANY (!J eh6rd ])e(a .field eo list r() ~+l(~ "11 <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.............*..........*.*****.*. <br /> <br /> <br /> <br />ItECBARICAL COMPANY <br />State Cert. or Resist. . <br />Signature City License Registration . <br />........................................*. <br /> <br />OTRRR COMPANY <br />State Cert. or ReSist. . <br />Signature City License Registration . <br />......................................*... <br /> <br />APPLICATION APPROVED BY PERIIIT OPFIC~. <br />