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<br />~," .....,. '...~ '.... -. ~"""'''''''-"'''- ,~.,-='y...!'t" <br /> <br />APPLICAnON FOR PBRKIT <br />CITY OF ZEPIIYRBILLS <br />BUILDING DEPARTHENT <br /> <br />OWNER'S NAHK ,.: '-t.' J('l?....e <br /> <br />Q ~ <br />\ \of' Art. cl <br />0'1 <br />'" \ c\S t" Lt d<J. '/ <br /> <br />PHONE <br /> <br />OWIIER'S ADDllBSS (n j '4 I <br />JOB ADDRESS S-' f) i11 .",,- <br /> <br />........ <br /> <br />LEGAL DESCIlIP'lION: LOT(S) BtoCIL.-SUBDIVISION 2~).n RI d5~ <br />PARCEL LD.'':;' 2" :l. ( 0 I "bo CG6GO c~ 73C (OBTAIN FROM. PROPERTY TAX NOTICE) <br />WORK PROPOSED:~ew CoDstruction ---Addition --...Alteration -.Jlepair _Install <br /> <br />_Si8l1 <br /> <br />-.JIove <br /> <br />~lish <br /> <br />PROPOSED USE: ~iDg1e Faaily <br /> <br />_ec-ercial <br /> <br />--.Jf./F _' of Units --.Jf./H <br />_Indust. 4SWia. Pool _OtJ;1er <br /> <br />Restaurant &: Health Departaent Approval <br />DESCRIPTIOII OF WORK: Q QA( t...(( '-'l 'f<, gc L <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDERTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PI.OT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORKS. <br />ArlACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PBRKITS REQUESTED <br /> <br />~UILDING <br /> <br />$ ,3 3t:, I> 00 <br /> <br />Valuation of Total Construction <br /> <br />RI.RcrBICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />--"BawnCAL <br /> <br />$ <br /> <br />Valuation of Kecbanica1 Installation <br /> <br />.-PLUKBDlG GAS ROOFING <br />TYPE QF COIISTRUCTION: ~loclt _Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FIIIISIIED .FLOOR ELEVAnOIlS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AIlEAT <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />BIITJ.DRR <br /> <br /> <br />COBTRACTOR SECTION <br /> <br />cotIPABY--1J.o rv,~~ t(j t-\J <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />RJs I;. '-- <br /> <br />c.pc cJ;).S5."-/~ <br /> <br />Sisnature <br /> <br />SionJlture <br /> <br />COMPANY '[k,A.JN 1\ /;z 2Jv #- J ,'€J kt ~-L Cu". t " <br />,- . " State Cert. or Regist.' ~, 'I <br />~....O'r"i/....",,:, '/jifJ,rt-t..~b. (; City License Registration . <br />. ....................................... <br /> <br />l'nU'D.&uv I' ,I" \ j, (1-)Q..,J~5 <br />UUDrftlU. f'.:t<.:, ., ~- rH..... v ! ~ "- <br />State Cert. or Regist.' <::,Pc c J.. ",-~V-~ <br />~ll {Q.~7 City License Registration' <br />.......................................... <br /> <br />PLlDlBER <br /> <br />~~; <br />Signature' ", <br /> <br />/ <br /> <br />IlECllANICAL COHPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />OTRRR COHPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />APPLICAnOIl APPROVED BY PBRKIT OFFICER. <br />