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<br />.",~~,~ ''';"''''-::;1-'' ""r~:II!"""",~;,~",'~_",~~~I""""'" <br /> <br />APPLICAnON FOR PERHIT <br />CITY OF ZEPBYRBILLS <br />BUILDDtG DEPAR'l'HBliT <br /> <br />JOB ADDRESS <br /> <br />~lJdtZ " PfJr!n) <br />71552. N 21rd <br />3845' I E, (! J( ,S4 <br /> <br />PHONE <br /> <br />H j 'J,j 7fi:j, ,'5(,,;"1 .~ <br />I <br /> <br />OWNER' S IIAH.E <br /> <br />OWIER'S ADDBESS <br /> <br />,) , <br />(. .. -h*'" y f I <br />, <br /> <br />2p/JhY'r/JlJ/< PI _ _~351-() <br /> <br />........ <br /> <br />LEGAL DESCRIP'fiON: LOT(S) <br /> <br />~SUBDIVISION <br /> <br />PARCEL LD.' <br /> <br />(OBTAIN FROM PImPERTY TAX NOTICE) <br /> <br />won PROPOS.ED:~ew Construction ~ition ~teration -.Jlepair _Install <br /> <br />_Sign <br /> <br />--.JIove <br /> <br />-Peaolish <br /> <br />PROPOSED USE: _Siogle Faaily <br /> <br />----It/F <br /> <br />_' of Units ----It/H <br /> <br />_ec-ercia1 _IDdust. _Swia. Pool _O~er <br />)(' Restaurant &: Health Departaent Approval <br /> <br />DESCRIPTIOB OF WORK: <br /> <br />BUlLDDtG SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RUIDERTUL: ATTACH (2) PLOT PLAlfS &: (2) SETS OF BUlLDDtG PLAHS &: (1) SBT BURGY FORMS. <br />COHHERCIAL: ArlACH (3) SETS OF BUILDDtG PLAlfS &: (1) SET ENERGY FOlUtS. <br />, <br />PROPERTY SURVEY REQUIBED FOR ALL II.EW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />~UILDDtG <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />V' RT.RCTRICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.B.C. <br /> <br />~CAL <br />...L.PLUllBDG <br /> <br />$ <br /> <br />Valuation of Kecbanica1 Installation <br /> <br />GAS <br /> <br />ROOFDtG <br /> <br />SPECIALTY <br /> <br />TYPE OF mJlSTRUCrIOB: ---.Block ---",raae _Steel <br /> <br />Other <br /> <br />PDIISII.ED FLOOK ELEVAnollS: <br /> <br />FT. <br /> <br />IS PROJEC'l IN FLOOD ZONE AREA! <br /> <br />YES NO <br /> <br />....**.................................... <br /> <br />BIITT.DRR <br /> <br />. COliTRACTOR SECTION <br /> <br />vLAWiIA- COKPAIIY ,MIJ_I3~ (;WS7i~j/(B{)NJ INl <br />) State Cert. or Ile8iBt. . & ('11 ~~2~ I <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />. =-=: ~ COHPAIlY 8M" L. hr<.IP~J nf <br />State Cert. or Regist.' €E-O,Q l/Slf3 <br />t ~ . City LicelUle Ile8iBtratioo. /,f. /'z:, <br />.......................................... <br /> <br /> <br />PLIDlRRR ~~ COHPAIlY <br />/J. . State Cert. or Regist. . <br />Sigoature ~~ ~ City License Registration.' <br />, '.......................................... <br /> <br />tI KEClWiICAL COHPAIlY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />v?( <br /> <br />C:.3 <br /> <br />OJ(~ <br /> <br />Sigoature <br /> <br />OTRRR COHPAliY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />APPLICAnOB APPROVED BY PERMIT OFFICER. <br />