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<br />... --'''''' y~' """".' ".... -c,-., ""'_~i7'-:,-~~';Nl'"....,..I/l'~,;p;'IlIt""""_<"",,,'~'~~~!.'f;~i, <br /> <br />APPLICAfiON FOR PERMIT <br />CITY OFZEPIIYRIIILLS <br />BUILDDlG DBPAR'l"KENT <br /> <br />OWNER'S <br />OWNER'S ADDBBSS ((Jr., -::;)~ <br />JOB ADDRESS (C' (~"J-f/) <br /> <br /> <br />BONE 5) I ~'::).~ l'-r SeC)" - (c 1 QCf <br /> <br />-..... <br /> <br />LEGAL DESCRlP'fiON: LOT(S) BLOCIL.-.SUBDIVISION ~~ <br />PARCEL I.D..~~02..l.p-Ol\-CC;iol.o-OO~-<2C>lO (OBTAIN FROM PROPERTY TAX NOTICEl <br />WORK PROPOSED:~ew Construction ~ition --Alteration Repair _Install <br /> <br />--.J;igo. <br /> <br />--.JIove <br /> <br />->>e-olish <br /> <br />PROmSED USE: .xSingle Faaily <br />_ec-ercial <br /> <br />---Yt/F _' of Units ---Yt/H <br /> <br />_Indust. -5wia. Pool _Other <br /> <br />____estaurant &: Hea1thAepartaent Approval . <br /> <br />DBSaIIPTIOB OF -, ~. ~I\ oJl QJL;~4~~~ <br /> <br />BUlLDDlG SIZE: lOx 3S t ~e Feett~ Height lU UAS <br /> <br />RESIDERTlAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLAIIS &: (2) SETS OF BUlLDDlG PLANS &: (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUlLDDlG PLANS &: (1) SET ENERGY FOlUlS. <br />PROPERTY SURVEY BEQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />-BUlLDDlG <br /> <br />$~ It<;D~ <br /> <br />PERMITS REQUESTED <br />, <br />Valuation of Total Construction <br /> <br />RT.RcrRICAL <br /> <br />A!IP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />--lIECIIAIJICAL <br />--.J'LUIIBDG <br /> <br />$ <br /> <br />Valuation of llecbanica1 Installation <br /> <br />GAS <br /> <br />ROOFDlG <br /> <br />SPECIALTY <br /> <br />TYPE ()F mJlSTJWCrIOB: _B1ocIt _Fraae _Steel <br /> <br />Other <br /> <br />F1IIlSIIBD PI.OOll ELEVAfiOIlS: <br /> <br />Fl. <br /> <br />IS PROJECT DI FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... ' <br /> <br /> <br />COIlTRACTOR SE~ <br />COMPANY V~,COnotALttJt~ <br /> <br />tate Cert. or Regist. . <br />ty License Registration f .:g'''.J/,., <br />........................... <br /> <br />aml.DER <br /> <br />RT .Rr.'I'RTCIAIlI <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />SignAture <br /> <br />PLlDlBER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration f <br />.......................................... <br /> <br />IlECBAIlICAL <br /> <br />Sigoature <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration . <br />.......................................... <br /> <br />nTRRR <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration f <br />.......................................... <br /> <br />APPLICAfiOIl APPROVED BY <br /> <br />PERMIT OFFICER. <br />