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<br />APPLICAnON FOR PElUlI.T <br />CITY OF ZEPIIYlUIILLS <br />BUILDIRG DEPARTHENT <br /> <br />OWNER'S twm WfJ C; c:, fELL m ~ Q.h. OC...; N <br />OWlIER'S ADDRESS 8235 ~ N G:ELVl <br />JOB ADDRESS 4-7 55 <br /> <br />LEGAL DESCRIPTIOli: LOT(S) <br />PARCEL 1.D.# 9kCOR D <br /> <br />PHONE 180 -; '62..4- <br />COLJ R.T 1 'ZcPH 'f1CljILCS. FL 3.3.~4-1 <br />~; IL v~R Ct I7..CL EJ ZEPtI'IRf4Ju,S FL 3~s:S4- l <br />BI.OGIL-SUBDIVISIOli~ L F 0 NT V ILL I4S <br />PL\4T 'Bco/~?' \ P~~7o (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:..LNew Construction ~ition --^lteration -Jepair _Install <br /> <br />_Sign <br /> <br />--.JIove <br /> <br />_DeIIOlish <br /> <br />PROPOSED~E: ~~eF_i~ <br /> <br />---.Jt/F _' of Units _K/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />--..Restaurant &: Health Departaent Approval <br /> <br />DESCRIPTIOli OF WORK: <br /> <br />BUILDIRG SIZE: SCf ( X4-3'b7, ( I 'l/7 ~uare Feet, ?S ()4 Height wT ~.q vE 5 <br /> <br />RESIDEBTIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDIRG PLANS &: (1) SET ERERGY FORMS. <br />GOMKERGlAL: ATTACH (3) SETS OF BUILDIRG PLANS &: (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CORSTRUCTION. <br /> <br />~UILDIRG <br />V~.RC1'RICAL <br /> <br />~awnCAL <br />VPL~~ <br /> <br />$ <br /> <br />PERMITS REQUESTED <br /> <br />Valuation of Total Construction <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />J ()O AIIP Service <br /> <br />VPlorida Power Corp. <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPEGIALTY <br /> <br />TYPE 9F COIISTRUC'l'IOli: ~loclt _Fraae _Steel <br /> <br />Other <br /> <br />FDISIIBD FI.OOK ELEVAnORS: .,,', FT. <br /> <br />BI~I.DRR <br /> <br />Q~ <br /> <br />Signature <br /> <br />Rl.RCTRICIAIII <br />Signature ~Ll. <br /> <br />PLOKBER. <br /> <br />Q~ <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />Q~_d^ <br /> <br />Signature <br /> <br />OTRRR <br /> <br />Signature <br /> <br />IS PROJEct IIi FLOOD ZOO AREA' V <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRAcroR SECTION <br /> <br />CDlPAIIY c;;?U3<;Et'_c.. ~ ~otv f...( <br />State Cert. or Regist. t C - C <<it:, t I <br />1'Y\. B}-1j~ City License Registration' 0 C~C D31btl <br />..........**........*........**........... <br /> <br />COMPANY (RUSSELL <br />o State Gert. or Regist. # )::::.. <br />m. D t1yu/V\...... City License Registration # ":> <br />......*................................... <br /> <br />COKPANY qU.sSELL Wl ~Row"l <br />r;) State Gert. or Regist. t eFC.. D?:"Q4Ci (., <br />m. .n~ City License Registration' 4--( C F Co '3 q q q (, <br />......*................................... <br /> <br />COKPANY 9 uss<0Z c n7. 73 1<.0 {.u ,,~ <br />'iJ State Cert. or Regist. # C J4 Co 4-/254- <br />111. .D ).o~ City License Registration' 3'6 C 14 Co 4-( z::;;4- <br />*....***.....*.*..*.....*****....*.*..*..* <br /> <br /> <br />GOKPANY <br />State Gert. or Regist. # <br />City License Registration # <br />.**...~.**....**............**...........* <br /> <br />APPLICATIOII APPIIOVBD BY )f4~A~ m __~ <br /> <br />PElUlI.T OFFICER. <br />