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<br />APPLlCAnON FOR PERKIT <br />CITY OF ZEPIIYRIIILLS <br />BUlLDIRG DEPARTHERT <br /> <br />OWRER'S IWtE (),/3 II Ice ;A ( <br />OWRER'S ADDUSS r S.:?: 0 <br />JOB ADDRESS 31::;-0(0 <br /> <br />We f(;t1if- <br />y/FF/--v At/' <br />~LL+~ ~uC2- <br /> <br />PHONE(901.)07~ - /c0.:3 / <br />srr/~~ ~LL Fe ~r60? <br /> <br />LEGAL DESCRIP'I'ION: LOT(S) <br /> <br />BI.OCX...--SUBDIVISION <br /> <br />PARCEL LD.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br /> . ~teration <br />WORK PROPOSED:~ew Construction ---..Addition -.Jlepair _Install <br /> _Sign ----IIove _Deaolish <br />PROPOSED USE: _Single Faaily --.Jt/F _' of Units _M/H <br /> keo-ercial _Indust. _Swia. Pool _Other <br /> <br />-Restaurant It Health Depart:aent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />c. C',..-vvrrT( yO <br /> <br />v-u-v <br /> <br />A4~Y--c-r5 <br /> <br />~/ce. <br />.lJc.fot I ~ fioh J' <br /> <br />BUILDING SIZE: /'5 X 30. <br /> <br />Square Feet. / r Height <br /> <br />RESIDERTIAL: ATTACH (2) PLOT PLARS It (2) SETS OF BUILDING PLANS It (1) SET ENERGY FORMS. <br />COMMERCIAL: ATtACH (3) SETS OF BUlLDIRG PLANS It (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REQUESTED <br /> <br />~UlLDIRG <br /> <br />Va1uation of Total Construction <br />AIIP Service ~Jlorida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_ELECTRICAL <br /> <br />--1IECIIAlIICAL <br /> <br />$. <br /> <br />Va1uation of Mecbanica1 Installation <br /> <br />_PLutlBIRG GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CORSTRUcnOR: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FlRISBED FI.OOR ELEVAnOIfS: <br /> <br />Fl. <br /> <br />IS PROJEC'l IN FLOOD ZORE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CORTRAC'lOR SEC'lION <br /> <br />BIJTIDRR <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br /> <br />COMPANY r=;:?f C{a.SS <br />State Cert. or Regist. . <br />City License Registration . <br />............................... <br /> <br />l={ecT- <br /> <br />/~ <br />r __ <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />tlECBARICAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />OTRRR ~ (r~CJr~ ~~"-,,.,~r COMPANY 2-ef)/-I t/fl- }/ct-L S <br /> <br />~ ~ State Cert. or Regist. . <br />Signature "' d ~ City License Registration' <br />~ ......................~................... <br /> <br />A/'frt/ Y <br /> <br />APPLICAnOR APPROVED (BY <br /> <br />PERMIT OFFICER. <br /> <br />'. <br /> <br />.. <br />