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<br />APPLICATION FOR PElUlIT <br />CITY OF ZEPIIYRBILLS <br />BUILDING DEPAR'1'HEHT <br /> <br />-SQ. t.r'Q ?..1F- <br />/;2 , (;2 r - 9'..::;-- <br /><I-B <br /> <br />OWNER'S HAHE I?Ay t/i///iJe ~IA JLIJ el2s <br />OWNER'S ADDRESS /965/ PJ2fAGe ,s,; /JC/WfrS <br />JOB ADDRESS /- 8 L,tJ/AlfeLtW<<J..I) .fJ.R.J ve ~ Y / I <br /> <br />PHONE 99/- ? ~6 6 " . <br /> <br />_Sign <br /> <br />---..Hove <br /> <br />--Peaolish <br /> <br />PROPOSED USE: )( Single Faally <br /> <br />---..H/F _, ofUllits ----1I/B <br /> <br />_ec:-ercial <br /> <br />. <br />_lDdust. _swia. Pool ,_Other <br /> <br />---..Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: SJPc9Le F.4/YJ/lv ~P.$' <br />/ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDEHTIAL: AtTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET BBERGY FORKS. <br />COMMERCIAL: AtTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />IU .F.CI'RI.CAL <br /> <br />PERMITS REOUESTED <br />$ 5cJ,000 Valuation of Total Construction <br />. <br /> <br />/6 (J AlIP Service X Florida Power Corp. <br />$ :2 ')00 Valuation of lIechanical Installation <br /> <br />'1 ' <br /> <br />---.BUILDING <br /> <br />W.R.E.C. <br /> <br />---1IEClWUCAL <br /> <br />--PLUIIB:IHG <br /> <br />GAS <br /> <br />x' <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: X Block _Fraae _Steel, <br /> <br />Other <br /> <br />FIllI.SBED FLOOR ELEVAnOBS: <br /> <br />Fl. <br /> <br />IS PROJEct :IN FLOOD ZONE AREA? <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />CONTRACTOR SECTIOli' <br /> <br />BUTI.DQ. <br /> <br />Signature <br /> <br />RJk;;t <br /> <br />COMPANY '.4 f///)q .~ <br />~ State Cert. or llegiat. . <br />(JL City License Registration , <br />. ...................................... <br /> <br />, COMPANY 0 5' c:c::~ <br />~ State Cert. or Regist.' G-/l. ~ 2 (j ~5- <br />~ ' City License Registration', ~- ~r;;/7Z) <br />.......................................... ' . <br /> <br /> <br />~- <br /> <br />IU.RC'l'RICIAli <br />SiDnJlture ~~ t:f, <br /> <br />" <br /> <br />~ <br /> <br />PLUMB~ COMPANY <br />/ State Cert. <br />Sigo.ature.&"'40.-?~/i4' CUy License Registration , <br />.......................................... <br />r <br />llECBANTCAJ. ~' ~ COMPANY A.R_ G /}/)(/ COA/LJ <br />../} .'LJ State Cert. or Regist. . c AC 6.?~~ <br />Signature /J,/f\,.C ~/~ CP/II-tJ , City License Registration f 1;#/ ~ <br />~.......................................... <br /> <br /> <br />~/~ <br /> <br />L---" <br /> <br />OTRF.R COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />..**.**..........*........................ <br /> <br />APPLlCAnOH APPROVED BY PERHlT OFnCEa. <br />