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<br />ADDRESS <br /> <br />11-:;_~ '~~::;.~r :J t ~ <br /> <br />~~vu- d:;~()b\' " . -- ,.:... c . ..;~'H.' <br />\\~ 5.~~~ C~<!1';~rSfo"-'~ <br />OWNER -2ltt~ ~ " <br />3<c4-DI ~~ :::S-~~~LOT SIZE <br /> <br />AfPLtCAT10N FOR PERMIT <br />CI.TY OP'ZEPHYRHI.LLS <br />BUILDING DEPARTMENT ' " . . <br /> <br />APPLICANT <br /> <br />)C <br /> <br />"- <br />AREA SQ. FT. <br /> <br />JOB LOCATION <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLO,CK ' <br /> <br />SUBDIVISION ' <br />" ."; . . , . ."'" <br /> <br />PARCEL I.D.4. <br /> <br />WORK PROPOSED:____New Construction ----Addition ~lteration ----Repair ____Install <br /> <br />: ,", <br /> <br />____Sign/Temp. <br />PROPOSED USE: ~Single Family <br /> <br />_Sign <br /> <br />____Move ----pemolish <br /> <br />~/F <br /> <br />____~ of Units .~/H <br /> <br />____commercial <br /> <br />~Indust. <br /> <br />____Swim. Pool Other <br /> <br />____Restaurant & Health Department APproval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />:pF.RMTT~ REOIIESTED <br /> <br />_BUILDING <br /> <br />$_ :2 \ \c:c>. Q::) <br /> <br />Valuation of Total Construction <br /> <br />____ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida power Corp. <br /> <br />W.R.E.C. <br /> <br />. <br />____PLUMBING <br /> <br />GAS <br /> <br />Valuation of Mechanical Installation <br />~ ROOFING SPE~IALTY <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />.0#' . <br /> <br />TYPE OF CONSTRUCTION: _Block _Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />~ONTRACTOR ~ECTION <br />Company <br />State Cert. or Resist. # <br />City License Regis~ration ~ <br />************************************.****. <br /> <br /> <br />Signature <br /> <br /> <br />Signatt,lre <br /> <br />/ <br />/ <br /> <br />... <br /> <br />Company <br />State Cert. or Resist. # <br />City License Registratio <br />*************************************** * <br /> <br /> <br />:~:::::::A~ . <br /> <br />/' <br />/ <br /> <br />Company <br />. State Cert. or R~gist. # <br />_ City License Registration <br />***************************************** <br /> <br />PUTMRER <br /> <br />MECHAN1CAT. I <br /> <br />Signature ,./ <br />****************************************** <br /> <br />OTHER ~m\ Company s...~~' (i"~c-ts.~~~ <br />State Cert. or Regist. 4. ~~QQS<o"(o'"3. <br />Signature ' - .~ City License Registration ~ ~.. <br /> <br /> <br />****************************************** <br />, <br /> <br />PERMIT OFFICER. <br /> <br />APPLICATION APPROVED BY <br />