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<br />---'.......-......~ ...-.........~--"""..,.......,'. <br /> <br />APPLICATION FOR PBRKIT <br />CITY OF ZEPIIYRBILLS <br />BUILDING DSPARTIIENT <br /> <br />_'S IWlIl - ~ <br />OWNER' S ADDKBSS . <br />JOB ADDRESS <br /> <br />::D:'~0lI1 U1T(S>~-\. [Uf.1-zlB~ SDBDI:~~~~~~ <br /> <br />PHONE <br /> <br />?H/tJ~// <br /> <br /> .: I" I <br />WORK PROPOSED:--.l:...New Coostruction \ <br />---....Addition --..A1teration ..-epair _lDstall <br /> ---.Sign ----Ifove ---Peaolish <br />PROPOSED USE: ---'single Faaily ---1t1 F __, of Units ----1:f/B <br /> ...Lec-ercia1 _Indust. _Swia. Pool _Other <br /> <br />. ---..Restaurant &: Health Departaent Approval <br /> <br />DBSCRIPnOll OF _. 71~ ~ ~kt <br /> <br />. 19/)[) sq~re Feet, ~,Z' Height <br /> <br />BUILDIBG SIZE: <br /> <br />x <br /> <br />RESIDEIITIAL: <br />COHKERCIAL : <br /> <br />, <br />i..i.. <br />A1TAaI (2) PLOT PlANS &: (2) SETS OF BUlLDIBG PLANS &: (1) SIT BDRGY"FORMS. <br />ATrACII (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORHS. I....... 1" . <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.' . <br />I' <br /> <br />PERMITS REQUESTED <br /> <br />I. . <br /> <br />! <br />. <br />,~. <br /> <br />~UlLDIBG <br />,/ RI.RCTRICAL <br />~CAL <br /> <br />$ ~~()/()dO ~ - <br /> <br />Valuation of Total Construction <br /> <br />'1 <br /> <br />f. ; . <br /> <br />AHP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.B.C. <br /> <br />$ <br /> <br />S-OJ <:> 0 0,- <br />, <br /> <br />Valuation of lIecbanica1 lDstallation <br /> <br />, <br />! <br /> <br />- <br />- <br /> <br />2:::.JLUKBDfG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TlPE QF COIISTRUCTION: ~loclt _Fraae _Steel <br /> <br />Other <br /> <br />PIlISBID FJ.OOR ELEVAnOIS: <br /> <br />n. <br /> <br />IS PROJEct IR FLOOD ZOIE AREA! <br /> <br />~ <br />- <br /> <br />.......................................... <br /> <br />YES <br /> <br />10 <br /> <br />BUTI.DER <br /> <br />mIITIlAI:lV& ~ _ <br />/flI~~'Kh2 :e~~ ~ ~J~?~ <br />~ (~ City License Registration' ~~4 <br />*************.**.*..**..*********.*.*...** <br /> <br />Signature <br /> <br />Rl.RCT.RICIAII <br /> <br />COMPANY /!j?~ a~ <br />State Cert. or Regist. . <br />City License Registration . <br />**********.*******.*.********.**.*..*.**.. <br /> <br />fl · 7--nh~ ~ :e~h:".#t~6i:~:' <br /> <br />~r. ~ City License Regi~~~iOn .. . ./R " <br />***************.*****..********.***.*.*.*. ! .,J: :,' <br /> <br />....2 / JY <br /> <br />SiDnAture <br /> <br />: . <br /> <br />PUDlRRR <br /> <br />Signature <br /> <br />IlEClWITCAI. ~ _ <br />Sipature ,{~~ City License Regis tion'. <br />.*...*.******.***.*.*.*...*.*..*.*.****... . <br /> <br /> <br />.:" .. ..\ : . <br />h <br />. <br />, <br />, <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration': <br />.****.********.**.**.*.*.*.*.***..*.....*. <br /> <br />-'....' ' <br /> <br />Signature <br /> <br />..' ',t ',,' <br /> <br />APPLICAnON APPROVED BY <br /> <br />PBRKIT OFFICER. <br />'; . <br />i <br />