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<br />APPLICATION FOR PERK1T <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARTKENT <br /> <br />OWNER'S NAME Ct4/11 Iw./ ~~ ~M <br />OWNER'S ADDRESS ~~ >Oc/~ ~; 1-. <br />JOB ADDRESS ~~. 9- <br /> <br />~/,\,~ <br />'~/Ud, <br /> <br />PHONE <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition ---"lteration _Repair _Install <br /> _Sign _Move _Deaolish <br />PROPOSED USE: _Single Faaily _M/F _' of Units _KID <br /> *ec-ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant &: Health Departaent Approval <br />DESCRIPTION OF WORK: ?LfJ ~,/r1~- <br />BUILDING SIZE: Ux, Square Feet, Beight <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 FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction. <br /> <br />_ELECTRICAL <br />_MECBAlfICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Frlme _Steel <br /> <br />Other <br /> <br />FDU.SBED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />****************************************** <br /> <br />ELECTRICIAR COMPANY <br />State Cert. or Regist. . <br />SiQnAture City License Registration t <br />****************************************** <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration , <br />****************************************** <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration . <br />****************************************** <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />icense Registration # <br />************************* **************** <br /> <br /> <br /> <br />APPLICATION APPROVED BY PERK1T OFFICER. <br />