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<br /> <br />APPLICAnON FOR PERKIT <br />CITY OF ZEPIIYRBILLS <br />BUILDING DEPAR'llIENT <br />~s/x/c" M~hS <br />r:BeJJ / I ~ z- .s' pul JI /Zt6 j),#- <br /> <br />L//tfJ/ ~y /y// /v,h 7Z ~3.rl/9' <br /> <br />3R4/[/ 5L/e Z-lIfL. 35.510 <br /> <br />.~ '.. <br /> <br />1'ouj6 <br /> <br />OWNER I S <br /> <br />~F <br />ONE <br /> <br />OWRER I S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRlPTION: LOT(S) <br /> <br />BI.OCL--SUBDIVISION <br /> <br />PARCEL I.D.' (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:---.Jiew Construction --."Addition ---Alteration ~pair _Install <br /> <br />_Sign <br /> <br />-.JIove <br /> <br />-Deaolish <br /> <br />PROPOSED USE: -8iDgle Faaily <br /> <br />--1J./F _' of Units --1J./H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />---..Restaurant & Bea1th Departaent Approval <br />DESCRIPTIOB OF WORK: Kef LACF- Ex IS/JtJC, A IlL GJJ J) JTlv tV ) t0~ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDDTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET DERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~UlLDING <br /> <br />:* /1 Z 29' ~ <br /> <br />PERMITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />RI-ECTRICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />--..HECllAllICAL <br /> <br />$. <br /> <br />Valuation of Hechanical Installation <br /> <br />-PLUHBIlfG <br /> <br />GAS <br /> <br />ROOFIlfG <br /> <br />SPECIALTY . <br /> <br />TYPE OF COBSTKUcnOB: --Block _Fraae _Steel <br /> <br />Other <br /> <br />FIlUSBED .FLOOB. ELEVAfiOBS: <br /> <br />Fr. <br /> <br />IS PROJEC'l IB FLOOD ZONE AREAl <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />.. <br /> <br />Bun.DER <br /> <br />aiHPAIIY <br />State Cert. or Regist. . <br />City License Registration , <br />.......................................... <br /> <br />Signature <br /> <br />RT.IlCTIIICI.AII ~ COIIPAIIY ':2. ~l,-\ , '-.....s. S '-~C:-~ ' <br />~~=~~: ~~. ffi State Cert. or Regist. . Ot.:ll~~\~ <br />e. City License Registration' l D <br />. .. .. ................................. <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration . <br />.......................................... <br /> <br />IlECBANICAL COKPANY c AI <br />State Cert. or Regist. . <br />Signature City License Registration . <br />............................... <br /> <br /> <br /> <br />omRR COHPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />