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<br />", 'l"~.-~.~......_~~.t"~'t"";"':""" <br /> <br />APPLICAnON FOR PERMIT <br />CITY OF ZEPIIYlUIILLS <br />BUILDING DEPARTIIENT <br /> <br />OWNER'S NAHE :=;ArJE f.3((J:JVJf:-l PHONE )?13 7/ S'- ~ <.::> <br />OWNER'S ADDBESS '3 ~9 0 <;. A./OL 7H AVE y ~c:Jl:iJ.J l.f.(, LL J / ;::L~ 5' 3JY 0 <br />JOB ADDRESS '3 '?<t 0 C. ';uO.c:{,,/.J Av L- ........;22 ../'104 '1 .,e. l.L!/ .FL. ~ 3JV b <br />LEGAL DESClUPTION: LOT(S)~Jr: J t. I n. l<f BI.OCL.ti..SUBDIVISION <br />IV IJ~ 'o~ Mn:1 <br />PARCEL I.D.' ;;;t.C; 21- U 0010 C'-Il.IOO 01 yo 001 (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction --Addition ---..Alteration ---Repair _Install. <br /> <br />_Sign <br /> <br />--.JIove <br /> <br />--PeIIolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />---.Jf./F _' of Units ----"'/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />---Restaurant & Health Departaent Approval <br />DESCRIPTIO. OF WORK: IIV~TALL.. !=;.<-l.-A LA.u--. SyJrc,..,..,..-? <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACII (2) PLOT PI..ANS 6( (2) SETS OF BUILDING PLANS 6( (1) SET ENERGY FORKS. <br />COItHERCIAL: ArlACH (3) SETS OF BUILDING PLANS 6( (1) SET ENERGY FORHS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CO.STRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />~UILDING <br /> <br />$. <br /> <br />'3~at:>. 00 <br /> <br />Valuation of Total Construction <br /> <br />-ELECl'IUCAL <br />---.JIECIWIICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />N.R.E.C. <br /> <br />$. <br /> <br />Valuation of llecbanica1 Installation <br /> <br />--.J'LtllBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE QF OOIISDUC'I'ION: _Block _Fra8If! _Steel <br /> <br />Other <br /> <br />FDISIIID P1OOB. BLEVAnORS: <br /> <br />Fl. <br /> <br />IS PBOJECr IN FLOOD ZONE AREA' <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />............ . <br />R.u.At..AL;-. {t~t.l4>v\U" <br />Mffl.R mtlPANY A'~J IS y ~n.tf"tA <br />/J '\.....-/ State Cert. or B.egist. I J!=7F- oooo<!Y / <br />Signature { ---- City License Registration' ,"q<t <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />RI.R.CTRTr.T .&.111 COMPANY <br />State Cert. or Regist. , <br />Siooature City License Registration , <br />.......................................... <br /> <br />PLlDlBER COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />.......................................... <br /> <br />IlECIIANlCAL COMPANY <br />State Cert. or Regist. I <br />Signature City License Registration . <br />.......................................... <br /> <br />OTRRR COHPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />................,......................... <br /> <br />APPLICAnOR APPROVED BY PERHH OFFICER. <br />'f <br />