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<br />"'~.."~'T:~. ,. ..._..!'9'11"!....,.,.....,- <br /> <br />~...,..".e.'..^e,'~."_-==-_:::"',.~'..~~__ .. <br /> <br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYlUIILLS <br />BUILDING DEPAR'l'HEI11' <br /> <br />\~I~I~I.~'t" (l.C.J/\ j) ~e~V'k;ll<k,PHONE <br />,R ~ -=>___'" eJ\..< <br />~ It;; S'\ <br /> <br />~15 <br /> <br />/~2'1bI5 <br /> <br />OWNER'S IINIK <br /> <br />OWlIER'S ADDRESS S" J.. \ L <br />JOB ADDRESS .s '2 0 I <br /> <br />......... <br /> <br />LEGAL DESCRIP'lION: LOT(S)--.J ) ?..~ ~ <br />/1- ?-b- ?- 1.... <br />PARCEL I.D.I 0C/ 10 - ~<6t4 00 - 00\ 0 (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED: /New Construction ----..Addition ---Alteration --.Jtepair _Install <br /> <br />B~SUBDIVISION <br /> <br />c.-~ * 2.. kJL< <br /> <br />--1!Jign <br /> <br />--.JIove <br /> <br />->>eaolish <br /> <br />PROPOSED USE: --1!Jingle Faaily <br /> <br />---"IF <br /> <br />_' of Units <br /> <br />---"/H <br />/ <br />~ther <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />Restaurant & Health Departaent Approval <br />DESCRIPTION OF WOlUt: -r;-lN\.~(Jy;;, ';; ~pI( P <br />BUILDING SIZE: X' .--- ~e Feet, ---------Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLUS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORKS. <br />COMMERCIAL: AftACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOBHS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />~UILDING <br />~.RcrnCAL <br /> <br />$ Valuation of Total Construction <br />I (J cJ AIIP Service /Florida Power Corp. <br /> <br />N.R.E.C. <br /> <br />~CAL <br /> <br />$ <br /> <br />Valuation of llechanica1 Inst:allation <br /> <br />-PLUIIBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE QF mRST.R.UC'l'IOIi: ~loclt _Fraae _Steel <br /> <br />Other <br /> <br />FIIIISJIBD PJ.OOR. ELEVAnORS: <br /> <br />FT. <br /> <br />IS P:R.O.JECT IN FLOOD ZONE ABEAT <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />j,;:,. " <br />NT,/Mi- (''l.i;~: r,,~ ','l. <br />J-/', _' -'-'Ji'f..) <br />BmT.DRR <br /> <br />mNTRACTOR SECTION <br /> <br />OOHPAIIY <br />State Cert. or Regist. I <br />City License Registration , <br />.......................................... <br /> <br />Signature <br /> <br />. <;;;~cU. . COIlPAIIY WOVC.7\" <, :+c~~ <br />~~=~~~ ~(~ State Cert. or Regist. , ,~ Q:J1C;, <br />City License Registration , '7 ~ I <br />.......................................... <br /> <br />PLUMBER 0 j( '__ A:, J fi <br /> <br />~ / <br /> <br />OOHPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />Signature <br /> <br />IlECllANICAL COMPANY <br />State Cert. or Regist. I <br />Signature City License Registration f <br />.......................................... <br /> <br />nTIIRR COMPANY <br />State Cert. or Regist. '- <br />Signature City License :Registration '- <br />.......................................... <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />