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<br />APPLICAnON FOR PERKIT <br />CITY OF ZEPIIYIUIlLLS <br />BUILDING DEPAR'l'HENT <br /> <br />OWNER'S IWIE ED DI1{.//S <br />OWNER'S ADDRESS 4R J () S tl2 ,"J /VA,)'€ .sr <br />JOB ADDRESS .s 1'1/Yl.E- <br /> <br />PHONE 7) S"-t)CJX <br /> <br />LEGAL DESClUP'llON: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL LD.' COBTAl;N FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED: v-liew Coastruction ~itiOD --Alteration ~pair _Install <br /> <br />~ign <br /> <br />---lIove <br /> <br />---PeIIolish <br /> <br />PROPOSED USE: ~iDg1e Faaily <br /> <br />--1l/F _, of Units -If./H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />Restaurant &: Health Departaent Approval <br /> <br />DESCRll"l'IOII OF WORK: <br /> <br />71t>o ..s ~ 70 S h'-E 0 , <br /> <br />BUILDING SIZE: ...f" X 9'. -2/ <br /> <br />Square Feet. g' <br /> <br />Height <br /> <br />RESlDEIITIAL: ATTACII (2) PLOT PLAIIS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />COHHERCIAL: ATrACII (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOBHS. <br />PROPERTY SU.RVEY REQUIRED FOR ALL NEW COIISTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />V'BUILDING <br /> <br />$ 27S-:Do <br /> <br />Valuatio~ of Total Construction <br /> <br />RT .RCJ'RI.CAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---1IECIWIICAL <br /> <br />$ <br /> <br />Valuation of Hechanica1 Installation <br /> <br />~UHBDiG GAS ROOFIIIG <br />TYPE 9F COIfST.RUC'fiON: __..Block ~Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FDrrSBBD FLOOB. ELEVAnOIlS: <br /> <br />Fl. <br /> <br />IS PROJEct I.N FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />Signature <br /> <br />CONTRACTOR SECTI.ON <br /> <br />mtlPAIIY liCE I9L U /"'. <br /> <br />/J /1/ L.-- I .. State Cert. or Regist. , C.RLt:>Jt/~.po <br />0I~~ City License Registration' c:?.3 <br />.......................................... <br /> <br />BlnI.DRR <br /> <br />RT .RCTRICI.AH <br /> <br />COHPAIIY . <br />State Cert. or Regist. , <br />City License Registration', <br />.......................................... <br /> <br />SilmAture <br /> <br />PLUMBER <br /> <br />COHPANY <br />State Cert. or Regist. , <br />City License .Registration , <br />.......................................... <br /> <br />-- <br /> <br />Signature <br /> <br />HEClWfICA:(. COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration . <br />.......................................... <br /> <br />OTRRR COHPAIIY <br />------.., State Cert. or Regist. , <br />Signature City License Registration , <br />.......................................... <br /> <br />APPLICATION APPBOVBD BY PERKIT OFFICER. <br />