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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARTKEHT <br /> <br />OWNER' 5 IWtE ~ a A..I C6>U -IJ--r <br />OWNER'S ADD'RESS G / ~ ( U7J2-Jlv L <) rI ' <br /> <br />PHONE? g,,;Z - S-'y / Y <br /> <br />JOB ADDRESS <br /> <br />s'"Ci /44 e <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL LD.' Ol - ciZG - .;;1.., 1- ~ - 0 <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction .-!addition -----Alteration _Repair _Install <br /> <br />_Sign <br /> <br />---.Hove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />---"'/F <br /> <br />_' of Units _K/H <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant &: Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />J 7 t!J,.J <br /> <br />A;/c <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 FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />':::---HEClWllCAL <br /> <br />$ <br /> <br />AIIP Service <br />"5 tr8tJ _ cJb <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />RT.RCTRICAL <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBIBG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />~.<~:'fjOo.~.,. ' <br />.4 ",. , i <br /> <br />... (;~,'!,J <br /> <br />TYPE OF COIiSTRUcnOIi: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FIllISBED FLOOR ELEVAnOIiS: <br /> <br />Fl. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />COIiTRACTOR SECTION <br /> <br />BIITT.DER <br /> <br />Signature <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />RT.RCTRICIAII.j COMPANY~<:::iM<'d (;kA..tr/~,t.tL t?L'~?TI'.lI<.' c:oJf./7" <br /> <br />/\// . / // /'l ') 1 State Cert. or Regist. . <br />SionAture / v{ ck-<t~ LA..t:f.'i!---e-jc!.ej City License Registration' 0 70( <br />I ****************************************** <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />****************************************** <br /> <br />IlECBANICAL COKPANY <br />State Cert. or Regis . . <br />Signature City License Registration f <br />****************************************** <br /> <br /> <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />