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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYlUIILLS <br />BUILDING DEPARTHENT <br /> <br />OWNER'S NAME //JAlN/ ~ S/lJlrH <br />OWNER'S ADDRESS S-P02.J jpIIL S"r <br />JOB ADDRESS s- /If?! ,E <br /> <br />PHONE...2/'''.. 1 />91 <br />Z Ep/I YR,H ILLS /7, ";'>..?Sl'tJ <br /> <br />LEGAL DESCRIP'I'ION: LOT(S) BLOCK SUBDIVISION <br />PARCEL I. D.' } 1- ~ b "';),,1- () () l/) - 0 7' IJ ().c:. {J;)..O tJ (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED: vNew Construction ----!tddition ---..Alteration ~epair _Install <br /> <br />_Sign <br /> <br />-"ove <br /> <br />_Deaolish <br /> <br />PROPOSED~E: ~~eF_ilY <br /> <br />-"'F _' of Units _MID <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />~estaurant &: Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />SC/<E~AJ ~Ol'l" do- /QoOF- <br /> <br />BUILDING SIZE: /0( X ~? dS{" <br /> <br />Square Feet, 9;p <f ' Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATrACII (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />ATrACII (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />e2;).. ~Lt ..OD <br /> <br />Valuation of Total Construction <br /> <br />_ELECI'RI.CAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-"ECBAlIICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />--PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY . <br /> <br />TYPE OF COllSTRUcnOR: _Block _Fr~ _Steel <br /> <br />Other <br /> <br />FIllISHED FLOOR ELEVATIONS: <br /> <br />Fr. <br /> <br />IS PROJECT IN FLOOD ZONE AREA'l <br /> <br />YES NO <br /> <br />.................................**.****** <br /> <br />CONTRACTOR SECTION <br /> <br />BUTlllER <br /> <br />il/PL <br /> <br />Acr .lJLif ",. <br />State Cert. or Regist. , CI!. CO..? ""tf"f} <br />City License Registration , ./&:.o <br />**.****..******.*********.*..**.********** <br /> <br />cdIIPAlIY <br /> <br />Signature <br /> <br />RT.RCTRICIAII <br /> <br />Si mUllture <br /> <br />COHPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.****..****.**.**.*.***.*..*.*..*********. <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.....*...********************.************ <br /> <br />Signature <br /> <br />HECllANICAL <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration f <br />.*.****...******.****...*....************* <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration t <br />...*......**.*****.*********..*.********** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />