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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYlUIILIS <br />BUILDING DEPARTMENT <br /> <br /><jfJ? r-- 'l~ oV <br /> <br />OIINER'S \WII\ &r ~ ~ <br />OWNER'S ADDRESS /965cJ~ Ai>fAcot< <br />d?1 r M <br />JOB ADDRESS fo:;f ,~>f rLJY12MAL <br /> <br />PHONE q91- '}.J bt <br /> <br />~ IJOWIV.5 <br />7Md <br /> <br />LEGAL DESCRIPl'ION: LOT(S) 58 BLOCKfJ,fJe SUBDIVISION Sl?ve~ t::>A/&' <br /> <br />PARCEL I. D. t 3 -;;; b -;;1/ - 0/6 (5 - 00000 -05'<;/ 0 (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:-L-New Construction _Addition --Alteration _Repair _Install <br /> <br />_Sign <br /> <br />---"ove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: ~single Faaily <br /> <br />_M/F _, of Units _M/H <br /> <br />_eo..ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Depart:llent Approval <br /> <br />DESCRIPTION OF WORK: .5>#9 L ~ <br />y <br /> <br />~Ai'.-?;/Ly <br /> <br />~e.r' <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL : <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />_BUILDING <br /> <br />PERKITS REOUESTED <br />$ jSCJO~ Valuation of Total Construction <br />, <br /> <br />,;;),00 AMP Service X Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_ELECTRICAL <br /> <br />~CHANlCAL <br /> <br />$ '5/c;e; <br /> <br />VaJuation of Mechanical Installation <br /> <br />_PLUMBING GAS ShlNj"e ROOFING <br />TYPE OF CONSTRUCTION: ~Block _Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FIIIl5BED FLOOR ELEVAUONS: <br /> <br />Fl' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />BIITT JlER <br /> <br />CONTRACTOR SECTION <br /> <br />COMPANY AA,f/ t/~/;"fe BhIL.lleE< <br />../) /J -L f:J State Cert. or Regist. t C~CO 3t;.:l'irCJ <br />~ f1 ______ City License Registration t /? 3' <br />**************************************** <br /> <br />(/"/ <br /> <br />Signature <br /> <br />RI.R.CTRTCIAN COMPANY S+~ ~eq~/c' <br />P. . State Cert. or Regist. t E.-f 05/37 <br />SianAture . 9r~ ~ City License Registration' ~~ <br />****************************************** <br /> <br />../ <br /> <br />Signature <br /> <br />LE// ~~ <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration . <br />****************************************** <br /> <br /> <br /> <br />v <br /> <br />PLUMBER <br /> <br />MECHANICAL <br />Signature c:t.t.' ~ <br /> <br />COMPANY A.f. C A/~ coli/I) <br />State Cert. or Regist. t t:AC t::J~J!7?1 <br />City License Registration t ~7~ <br />****************************************** <br /> <br />../' <br /> <br />OTRRR <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration . <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />!ltl~ '1 /11 r>T~ <br /> <br />PERMIT OFFICER. <br />