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<br />APPLICATIdN FOR PERKIT <br />CITY OF ZEPIIYlUIILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME <br /> <br />~ I6u Jo e //PcZ-n- <br />~719 ElA'l1V6 "))"e. <br />(XA // ~ / C/o. <br /> <br />PHONE <br /> <br />7.r ;:J, '- f./ J"2 S- <br /> <br />OWNER'S ADDRESS <br /> <br />LEGAL DESCRIP'l'ION: LOT(S) <br /> <br />2~4~1.I(s <br />, f <br />BLOCIL--SUBDIVISION <br /> <br />If. <br /> <br />~ 35 r-yo <br /> <br />JO~ ADDRESS <br /> <br />'fO/7 <br /> <br />PARCEL I.D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction -----..Addition ---..Alteration ~epair _Install <br /> <br />_Sign <br /> <br />-"<>ve <br /> <br />_Deaolish <br /> <br />P~POSED~E: ___S~eF_ily <br /> <br />-"IF <br /> <br />_' of Units _H./H <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />-Restaurant &: Health Departaent Approval <br /> <br />DESCRIP'l'ION OF WORK: <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 />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELEcnuCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />~CllAllICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUC'l'ION: _Block _F~e _Steel <br /> <br />Other <br /> <br />FDlISBED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />15 PROJEct' IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />RUTlDRR <br /> <br />COMPANY V cV A-/e 1/7 <br />/~A~ State Cert. or Reaist. . <br />City License Registration , <br />.......................................... <br /> <br />Signature <br /> <br />RI.RCTRICIAII <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration . <br />.......................................... <br /> <br />SiimAture_ <br /> <br />PLUMBER <br />Signature t/ <br /> <br />COKPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.....................................***** <br /> <br />IlECHANlGAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration , <br />.............*.***...*.....*....********.* <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration , <br />.............*.*.....**.*....**.**.**.***. <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />