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<br />APPLICAnON FOR PERIIIT <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARTKERT <br /> <br />OWNER'S lWIB Pe~: ~O <br />OWlIER'S ADDlIESS 3 9 .5" Lf .3 <br />3cf543 <br /> <br />c ~st.~\esL. (u ((cl ~ (\. <br /> <br />. <br /> <br />fheQ~we,C).4 kocp <br />Mea.. J w (") r~ ~ '- L c r:> f Z f7 A Y}-h ~ (l ~ <br />7'1 B~SUBDIVISION f1'lPa.J6wood Es~ps I <br /> <br />PHONE 7f?~- 7~76 <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />PARCEL LD.' <br /> <br />(OBTAIN FROM. PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction --.-.Addition ---J\lteration --Repair _Install <br /> <br />_Sign <br /> <br />--.-JIove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _S~e F_ily <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 />DESCRIPTIOII OF WORK: ':t <\... 5 ~ \ l <br /> <br />SCL-\-e. \\ ~-\-P V ( ~ ~ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RlmIDEBTIAL: <br />COHMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTAaI (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW COIISTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />-BUILDING <br /> <br />$ 5' 00 <br /> <br />Valuation of Total Construction <br /> <br />RT.RcnuCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />--'lECIWIlCAL <br /> <br />$ <br /> <br />Valuation of tlechanica1 Installation <br /> <br />_PLUMBDG GAS ROOPIRG <br />TYPE QF CORSTRUcnOIl: ____...lock _F~ _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />PDJISBED FLOOJl ELEVAnOIlS: <br /> <br />Fl. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />**..*....**..............*...*....*..*.*.. <br /> <br />CONTRACTOR SECTION <br /> <br />RIITT.DER <br /> <br />aJHPAIIY <br />State Cert. or Regist. . <br />City License Registration . <br />...................*..............*..*.... <br /> <br />Signature <br /> <br />RT.RCTRICIAR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />......*.*.......**..*.....*......*.**..... <br /> <br />Sianature <br /> <br />PLtDlBER <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration . <br />....**...............*.................**. <br /> <br />Signature <br /> <br />HECBARICAL COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.................*..............*...*..... <br /> <br />OTRRR ~ L COMPANY Gc9c>J 0'-'15 <br /> <br />c::::;;;;? State Cert. or Regist. . <br />Signatur . .Jeg,..,<( City License Registration . <br />~ .....*.............*.......*.......*..**.. <br /> <br /> <br />APPLICAnON APPROVED BY <br /> <br />PERMIT OFFICER. <br />