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<br />APPLICAnON FOR PERKIT <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARTHENT <br /> <br />OWNER'S NAHB ~'ill~ CA r_hL: S+OP~ t:-t1..... PRONE 7Jr~- o/5~ <br />, <br />OWNER'S ADDBESS 50 :L \ $: v "",,~ e,d, I:L:...U bt.. 21 ~/'I( S <br />JOB ADDRESS 50 :J . 5v "'",", VV\. t:/v(.. #+('(1 OIL 21 ,,-, ,( .5 <br />. <br /> <br />LEGAL DESCRIPrlON: LOT(S)// B~SUBDIVISION <br />PARCEL I.D.' J:L - ;(1:0-.;2(- 0100 - 00000 - 0110 (OBTAUI FROK PROPERTY TAX NOTICE) <br />WORK PROPOSED:-.Jiew Construction -..Addition --..Alteration ----..Repair / Install <br /> <br />_Sign <br /> <br />--.-JIove <br /> <br />--Peaolish <br /> <br />PROPOSED USE: hin&1e F_ily <br /> <br />----.Jt/F _' of Units ----.Jt/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swill. Pool _OtJ,ler <br /> <br />---Restaurant Ii Health Departaent Approval <br />DESCRIPTIO. OP WORK: i \1\ ')+..e:...l ~ Pi ~ v a.. c., t:e-ncc.. <.0 I H; j k <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDEIITIAL: <br />cotIMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS Ii (2) SETS OP BUILDING PLANS Ii (1) SET ENERGY PORMS. <br />ATTACH (3) SETS OP BUILDING PLANS Ii (1) SET ENERGY PORMS. <br />PROPERTY SURVEY REQUIRED POR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REOUESTED <br /> <br />--BUILDING <br /> <br />$ <br /> <br />If &9.00 <br /> <br />Valuation of Total Construction <br /> <br />RT.RcrRJ.CAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-"EawlICAL <br /> <br />s <br /> <br />Valuation of lIecbanica1 Installation <br /> <br />---PLUHBDiG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OP CORSTB.UcnON: --..Block _Fame _Steel <br /> <br />+CV\. Cot...- <br /> <br />Other <br /> <br />FIIIISBBD FLOOll ELBVAfiOBS: <br /> <br />Fr. <br /> <br />IS PBOJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />BMI.DRR <br /> <br />COHPAHY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />RT.RC'l'RTCIAII <br /> <br />COHPABY <br />State Cert. or Regist. . <br />City License Registration' <br />.......................................... <br /> <br />Si-ture <br /> <br />PLUHBER <br /> <br />COKPAHY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />IlECllARICAL <br /> <br />COHPABY <br />State Cert. or Regist. . <br />City License Registration f <br />.......................................... <br /> <br />Signature <br /> <br />OTRRR Fe r1C c. <br /> <br />COKPANY--....d ~ me l::;rlCL- <br />4 ~. State Cert. or Regist. . <br />(7 -ALdv]-7A ~ ~ City License Registration . <br />.......................................... <br /> <br />Signature ,</I. <br /> <br />/ 90 <br /> <br />APPLICAnON APPROVED BY <br /> <br />PERKIT OFPICER. <br />