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<br />APPLICATION FOR PERIIIT <br />CITY OF ZEPIIYRBILLS <br />BUILDING DEPARTtIERT <br /> <br />OWNER' S HAHB <br /> <br />L.4(/,t'F) '5 <br /> <br />6A/s~q".v'/?~,A// ffu//,: <br />, <br /> <br />~ rh~~L 7=~LL.s <br /> <br />PHONE <br />3" $..?""7"p <br /> <br />;7;Z - 7$L~.3 <br /> <br />OWNER' S ADDRESS 3.f1~4 <br />JOB ADDRESS ~ e...- <br />LEGAL DESCRIPTION: LOT(S) BLOCIL--SUBDIVISION <br />PARCEL I.D.' 11-J,.6-;)..!-OOIO-/b 700 - 6~/O (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:--...Wew Construction ---.Addition --J\1teration ~pair _Install <br /> <br />_Sign <br /> <br />-JIove <br /> <br />-Peaolish <br /> <br />PROPOSED USE: ~ingle Feaily <br /> <br />---.Jf./ F <br /> <br />_' of Units ---.Jf./S <br /> <br />-A.~rcial _Indust. _Swia. Pool _Other <br />--..Restaurant lr Health Departaent Approval <br />DESCRlPTIOIi OF WORlt: k/~L"e ~A! 6A/~/~pA//~ <br /> <br />BUlLDIliG SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDEIITIAL: AnACII (2) PLOT PLANS lr (2) SETS OF BUILDIliG PLANS &: (1) SET BOGY FORKS. <br />COtlHERCIAL: AnACII (3) SETS OF BUlLDIliG PLANS &: (1) SET EIiERGY FORHS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />~UlLDIRG <br /> <br />$. <br /> <br />Valuation of Total Construction <br /> <br />RI-RCTRICAL <br /> <br />---"EClWlICAL <br />-PLUHBIRG <br /> <br />$. <br /> <br />AIIP Service Florida Power Corp. <br />.." 5395'" ~ Valuation of lIechanical Installation <br /> <br />W.R.E.C. <br /> <br />GAS <br /> <br />ROOFIRG <br /> <br />SPECIALTY . <br /> <br />TYPE OF COllSTRUClIOIi: -Block -Fraae _Steel <br /> <br />Other <br /> <br />FIliISBBD FLOOR ELEVAnOIiS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />.' <br /> <br />BUTI.DER <br /> <br />COIIPAIIY <br />State Cert. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />R1.J!cnu~ . COIIPARY~A'~d~u-' <br /> <br />~ ~ ~~ State Cert. 0 gist. f <br />S{QDJlture ~ . Z?',41City License Registration' / '7~~ <br />... ................................... <br /> <br />Signature <br /> <br />PLUHBER <br /> <br />COHPABY <br />State Cert. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />Signature <br /> <br />IlECllABICAL <br /> <br /> <br />COHPABY -4#/1/ /-:- /{jN,..ve Y <br />State Cert. or Regist.' ~~~()~LJ&'?&7 <br />City License Registration . ~~ <br />................................... <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COIIPABY <br />State Cert. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />Siaoature <br /> <br />APPLICAnON APPROVED BY <br /> <br />PERIIIT OFFICER. <br />