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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPllYRllI.LLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAKE~IlA)E7f &,.)k~' <br />OWNER'S ADDRESS13 Lf Lf 6 A- L ( '13 t vb <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D.' <br /> <br />(OBTAIN FROM. PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction ~ddition -J\l.teration _Repair _Install <br /> _Sign --"ove _Deaolish <br />PROPOSED USE: _Single Faaily _KIF _' of Units _K/H <br /> ~ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK:JAJstA-L( ~b(2-~ St=eu;lZU:-( LtC, ifTS FurL 4-rt"'l <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING $ Valuation of Total constru:Jtftn <br />AObe). -Lf-O() U P(oob L(I:, ,-\-TS CPb\rto~ l L() c:lll60 <br />~LECTRICAL AMP Service Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_KECBARICAL <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />BlJII.DER <br /> <br />Signature <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />SilmAture <br /> <br />COMPANY () (SO I\( ~l C.- eD. l ,.JC <br />State Cert. or Regist.' E. c-<!:>oo 10 or L( <br />City License Registration' I.C)"? {p <br />****************************************** <br /> <br />F.I.RCTRICIAN <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />