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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYIUIILLS <br />BUILDING DEPARTKENT <br /> <br />OWNER'S RAKE fl1u,,- i1U,Ff <br />OWNER'S ADDRESS Lt?T - /3 J c:P t:JJ?' <br />JOB ADDRESS ..-r 4/JJ IC <br /> <br />PHONE <br />.-C /}tUA-;VL)/J A CJt),P <br /> <br />7f3-tL'P? <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION' <br />PARCEL 1.D.' /.1/-...Jb'-dl-t//60-.?'~-?'/...fP (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED: ~ew Construction ---..Addition ---..Alteration ~epair _Install <br /> <br />_Sign <br /> <br />--"ove <br /> <br />_DeIIolish <br /> <br />P~POSED~E: ~~eF~i~ <br /> <br />--"IF _' of Units --"IH <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />~estaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: CotJCR-~r$. - S/-I~D - C 19 ~O~r <br />7C:;~*"""'" <br />BUILDING SIZE: ~xJ/xR' I :/7r Square Feet, 9~?'Height <br /> <br />RESIDEIITIAL: ATtACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COHHERCIAL: ATtACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />P~PERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~UILDING <br /> <br />PERMI'lS REOUESTED <br /> <br />$ <br /> <br />..S>pt)o.Oi) <br /> <br />Valuation of Total Construction <br /> <br />_ELECI'RICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---1fECIWlICAL <br /> <br />$ <br /> <br />Valuation of Hecbanical Installation <br /> <br />_PLUNBIXG GAS ROOFING <br /> <br />SPECIALTY . <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FIllISHBD FLOOR ELEVAnONS: <br /> <br />Fl. <br /> <br />IS PROJECT IX FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER <br /> <br />~~I;L" . ." . *ARY /lCE /lLU""" <br /> <br />.~ State Cert. or Regist.' c.~ co..) tj b Po <br />_____ __ _____ City License Registration . dP-l <br />~ .......................................... <br /> <br />Signature <br /> <br />RT.RCTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Sion$lture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />HECllABICAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration f <br />...................................**.**** <br /> <br />Signature <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.*.........*..***................*....*.*. <br /> <br />APPLICAnON APPRoVED BY ~rr'l). PIlRIlIT OFFICER. <br />