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<br />APPLICAnON FOR PDKIT <br />CITY OF ZEPIIYRIIILLS <br />BUILDING DEPARl'HENT <br /> <br />OWNER'S twm ~ ~,..., ,7- <br />OWNER'S ADDRESS _ "? ~ .4 c,_ ( <br />JOB ADDRESS 3,8 4~ ( <br /> <br />/3d~ndj /?,/ <br />,-\"4- <br />,,,\{ <br /> <br />/~ c.v Y- <br />o / <br />/~'7 <br />I <br /> <br />.t::c.. J / <br />~s/. <br /> <br />PHONE 7118-S-f~ f <br />z- #,(1) <br />2- ~1i.J <br /> <br />.~ 3 S''fo <br />.5 :~ F<f6 <br /> <br />LEGAL DESClUPlION: LOT(S) BLOCK SUBDIVISION <br />PARCEL I.D.' :; - ;< ~ - Z I - <::1 0 /() - 0 S.J<j(J -00/ L- (OBTAllI FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:~ew Construction ----...Addition --...Alteration -.Jlepair _Install <br /> <br />_Sign <br /> <br />---Hove <br /> <br />--Peaolish <br /> <br />PROPOSED USE: ~iDg1e Faaily <br />~ec-ercial <br /> <br />---.Jt/F _' of Units ----"'/B <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />Restaurant & Health Departaent Approval <br /> <br />DESClUPlION OF WORK: <br /> <br />/A/SMLL <br /> <br />2 IoN .fO,v S)lS/c::'1l1 <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />. <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PI..ANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORKS. <br />COHHERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />RT.RCTRICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />N.R.E.C. <br /> <br />X-.tmCIIAUCAL <br /> <br />$ <br /> <br />/600 --- <br /> <br />Valuation of Hechanica1 Installation <br /> <br />-PLUHBDiG GAS ROOFING <br />TYPE OF CORSTRUCTION: ~loclt _Fraae LSteel <br /> <br />SPECIALTY . <br /> <br />Other <br /> <br />FIlIISHED FLOOR. ELEVAnORS: <br /> <br />F'l'. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />COHTRACTOR SECTION <br /> <br />RUTT .Dn COMPANY <br />State Cert. or Regist. I <br />Signature City License Registration , <br />.......................................... <br /> <br />,'. <br /> <br />RT.RC'l'RTCIAII COMPANY <br />State Cert. or Regist. , <br />SignAture City License Registration , <br />.......................................... <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />.......................................... <br /> <br />COMPANY ~17'~ T /,1/'~.:>y <br />State Cert. or Regist. I Z/:tfC'060;{ Zu <br />S1goature City License Registration . ~.f <br />................................. . <br /> <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />.......................................... <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />