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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPllYRllILLS <br />BUILDING DEPARTHENT <br /> <br />OWNER I S NAME <br /> <br />/Vt'J ~ 6 ~ rf- J vI; ct.,1 rz... <br />Ly n .6 reJ(J k /) r -z~ Ay I" l; ;'//.~ <br />/~ ~ -jf zy;A<jr 7,//1"5/ .cIVi <br /> <br />PHONE <br /> <br />OWNER I S ADDRESS V 0 (] /3 <br /><'730 <br /> <br />",c/.eft- <br /> <br />JQB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' (OBTAIN FROK PROPERTY TAX NOTICE) <br />WORK PROPOSED:~ew Construction _Addition ~teration _Repair _Install <br /> <br />_Sign <br /> <br /> <br />PROPOSED USE: ~ing1e Faaily <br /> <br />----..Kove <br /> <br />_Deaolish <br /> <br />----..KIF _' of Units _K/H <br /> <br />_<=<-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />_Restaurant &: Hea1th Departaent Approval <br /> <br />DJl:iMfl~"'~t::f:!, '5:~n.n/7d IJ.d1 ~ ,&7t? rOOd!.l: d~,e.;G <br />BUILDING SIZE: ~iI.. Square Feet'/II'JO Height <br />RESIDERTIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~ING <br /> <br />~Cl'RICAL <br /> <br />PERMI~S REOUESTED <br />$ ,,;;;L j .L/ t? cJ Valuation of Total Construction <br /> <br />AKP Service Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />--lIECII&lIICAL <br />~~G <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br />j' <br /> <br />TYPE OF CORSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FIlfISHED FlOOR ELEVAnONS: <br /> <br />FT. <br /> <br />IS PROJECI' IN FLOOD ZONE AREA '1 <br /> <br />YES NO <br /> <br />......................................**.* <br /> <br />PLmtBER <br /> <br /> <br />CONTRACTOR SECTION <br /> <br />COKPANY7:: ~lJd~ 1/ t- /feb6~r 1J1~.':JtJ/7 r 1 <br />State Cert. or Regist. . R~ 00 II "5 '2... <br />City License Registration' 41/ to <br />******..****************..*.*.************ <br /> <br />COMPANY D.p,A0 /.s ! If' -:::L tlJa j B/! oj ~ e <br />State Cert. or Regist. . <br />City License Registration' t7~7 <br />**.**.*.************.********* <br />I <br />'1 {'~!L} <br /> <br />BIJTI.DO <br /> <br />Signature <br /> <br /> <br />Signature <br /> <br />ItECllANICAL COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.*.....*.......*.***.**........****.*****. <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration t <br />****.***.********************************* <br /> <br />APPLlCAnON APPROVED BY PERMIT OFFICER. <br />