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<br />APPLICAnON FOR PERIIIT <br />CITY OF ZEPIIYRIIILLS <br />BUILDING DEPAR'l'KENT <br /> <br />OWNER'S NAMB <br /> <br />~ ~ H A rz.r Cec.vs YlGoc'f!lb,J- 12,...A.... <br /> <br />PHONE 90 L1- 521- ~7ot..-. <br /> <br />OWllIER'S ADDBBSS <br /> <br />JOJ' ADDRESS <br /> <br />'3~ 7rDr <br /> <br />~ ~ '1 ~ L,o.>- A, <br />2. <7 BLOClL-SUBDIVISION <br /> <br />o ~ ~(.Je:c_srT ~S ".. ~ <br /> <br />LEGAL DESClUP'lION: LDT(S) <br /> <br />PARCEL LD.' <br /> <br />Z-2..(o-2.) <br /> <br />Lo T Z. '7 <br /> <br />(OBTAIN FROM PROPERTY TAX NQTICE) <br /> <br />WORK PROPOSED:.--Rew CQnstruction ...6Mition ---Alteration --.Jlepair _Install <br /> <br />_Sign <br /> <br />--.JIove <br /> <br />->>eJIolish <br /> <br />PROPOSED USE: _Siogle F_ily <br /> <br />---1l/F <br /> <br />_, of Units <br />~iII. Pool <br /> <br />---1l/H <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Other <br /> <br />--.Jlestaurant &: Health Departllent Approval <br />DESCRIPTIO. OF WORK: St....:.l "'""" "" ~ ~ ~ p ~ 1 10 L c..1<... <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDBI1TL\L: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PIARS Ii: (2) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ERERGY FORKS. <br />PROPERTY SURVEY KEQUIRED FOR ALL NEW GOIISTRUGTION. <br /> <br />~UILDING <br /> <br />$~\7~ <br /> <br />PERKITS REQUESTED <br /> <br />Valuation of Total Construction <br /> <br />RI.RGTRICAL <br /> <br />AIIP Service <br /> <br />Florida Power Gorp. <br /> <br />W.R.E.C. <br /> <br />---1IECllABICAL <br />----.J'LUHBING <br /> <br />$. <br /> <br />Va1uation of llecbanica1 Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OP CORS'D.UCT101i: ..-Block _Praae _Steel <br /> <br />Other <br /> <br />FIRISBBD PLOOR ELEVAfiOIiS: <br /> <br />Fl. <br /> <br />IS PROJECT IN FLOOD ZONE AREA! <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />RUTlDO <br /> <br /> <br />GORTBAGTOR SECTION' <br /> <br />GOHPABY R'\iLo. PQel~ ::t:',,->~ <br />State Gert. or Regist.' c:.. pe. 0 (So b ~ c::.. <br />City License Registration' . I/;:L <br />.......................................... <br /> <br />Signature <br /> <br />= ~ ~ COIIPAIIY 1I~.:.s </"a~c... <br />State Gert. or Regist.' 2:...,.., 00 ~-a. <br />e ~ City License Registration.' :,;:,). / ~ <br />.......................................... <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />IlEClWiIGAL COMPANY <br />State Gert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />OTRRR GOHPABY <br />State Gert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />APPLICAnON APPROVED BY PERKIT OFFICER. <br />