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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPIIYlUIILLS <br />BUILDING DEPARTMENT <br /> <br />;Q ~. <br />\J).t-4-;_ 11-9S <br /> <br />OWNER'S NAME <br /> <br />I <br />~Z:;CP/C <br /> <br />,/3 /f,,fe P/ <br />,5'"s;r? /:L +;'1'/5;- five <br />I' <br /> <br />C>A/#~ <br /> <br />PHONE <br /> <br />/Fg--~s7~ <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL LD.' //- tJ-t- :;;/- 00/1) - d)/ fl.tJO-Ot) /0 <br /> <br />(OBTAIN FROK PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:+New COnstruction _Addition ~teration _Repair _Install <br /> _Sign _Kove _Deaolish <br />PROPOSED USE: _Single Faaily _KIF _' of Units _K/H <br /> _<=<-ercial _Indust. _Swim. Pool _Other <br /> <br />_Restaurant & Health Department Approval <br />DESCRIPTION OF WORK: C-A-/' /jr-~ <br />BUILDING SIZE: 02 f X jJ lj. / /~ Square Feet. ' ;q~ = 'eight <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 />~UILDING <br /> <br />PERMITS REOUESTED <br />/ / be?'. ~aluation of Total Construction <br />/ <br /> <br />$ <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />~GHANICAL <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br />TYPE OF CONSTRUCTION: _Block ----=::::Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />YES <br /> <br />~ <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />Signature <br /> <br />CONTRACTOR SECTION <br /> <br />y COMPANY /,L5 - ./ It ~-:7 /P;/V'" tr ' <br />L. ~ State Gert. or Regist.' 'oC/233S- <br />.P) 0', ./11 City License Registration' ~ '7 <br />*****' *** ******************************* <br /> <br />BIJTLDER . <br /> <br />SionAture <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration t <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration t <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration . <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />OTHF.R <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />