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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYlUIILLS <br />BUILDING DEPAR'l'HENT <br /> <br />OWR~'S NAHB ~([ ~ &Jiw. <br />OWRER'S ADDRESS ./7h~J ~~Il 13,~ <br />JOB ADDRESS L./99' k./W7~ rod 4 <br />LEGAL DESCRIPTION: I.OT(S) t/3 BI.OCK SUBDIVISION~~ (9-->A"e', <br />PARCEL I.D.' 3-d?6 -.;) J - 0/60- ~ 'd/~2) (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED~ew Construction ---..Addition ---..A1teration ----..Repair _Install <br /> <br />PHONE 19/-796/; <br />~; <br /> <br />_Sign <br /> <br />---.JIove <br /> <br />----Peaolish <br /> <br />PROPOSW~E:~s~eF~i~ <br /> <br />---li/F _' of Units ---li/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />'----..Resta~,ant & Bea1th Departaent APProv~ ) <br />DESCllIP'nOR OF 1iOlIK:~. F4n1/L,y A'P." \(o~. <br />BUILDING SIZE: X, Square Feet, Height <br /> <br />RESIDEBTIAL: ATrAGII (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />COMMERCIAL: ATrAGII (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />RI .F.CIRICAL <br /> <br />$ ~CJ. a:?O <br />, <br /> <br />';;00 A!IP Service <br />$ ~ 6610 <br /> <br />Valuation of Total Construction <br />X' Florida Power Corp. <br /> <br />" ' <br /> <br />--.JIUILDING <br /> <br />W.R.E.C. <br /> <br />---1fEGllAHICAL <br /> <br />-PLUMBING <br /> <br />GAS <br /> <br />Valuation of Mechanical Installation <br />#OOFIRG SPECIALTY <br />_Fr~e _Steel Other <br /> <br />TYPE OF CORSTRUcnON: <br /> <br />..2SJsloclt' <br /> <br />FIRISHBD FLOOR BLEVAnOBS: <br /> <br />Fr. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />*************************..*..........**** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION' <br /> <br />BlJJl.n~ COKPANY <br />~ ~ State Cert or ReEist. <br />Signature cA . City License Registration , <br />.. ..*****..********.**.********.*.*. <br /> <br /> <br />RI .F.C'l'RIGIAH <br />SilmAtureL ~,,~ ;:l, <br /> <br />COMPANY 4"'? 5" ~~~~~ ~____ <br />~ State Cert: or Regist. t G~~ z,"'<,,- ,!- <br />~./- ' City License Registration '. ..;z O/~- <br />****...*.**...................*.......... ' . <br /> <br />PLUMB~ <br /> <br />COMPANY IIAr/YlDN -+- Tjvtc,f'f'~ <br />' I j,( State Cert. or Resist. .<fr CJQ '(,; tfJ// <br />fA..) dJ ,) ~ '{e~ City License Registration I / rf.; L/ <br />*.***..*.***.***.*.*****.***......*.****.* . <br /> <br />afL~ <br /> <br />Signature <br /> <br />IlEGllANI~ <br />Signature ~ <br /> <br />COMPANY <br />State Cert. or Regist. I <br />.4 f e City License Registration #. <br />.**..*.*...**************.**.************* <br /> <br /> <br />OTRF.R <br /> <br />COMPANY <br />State Cert. or Regist. I <br />City License Registration . <br />.***.****.*.***.****.**********.********** <br /> <br />Signature <br /> <br />APPLI( <br /> <br />IN APPROVED BY <br /> <br />PERHlT OFFICER. <br />