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<br />APPLICAnON FOR PEBKIT <br />CITY OF ZEPIIYRIIILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER' S NAKB <br /> <br />V~ICR l( <br />L.tJT-..f..2 ift?6't?7 <br />S/7m~ <br /> <br />WY/JJtJ~,E <br />L /}t,JR,U/.J,4 <br /> <br />PHONE <br /> <br />'7 J>'J -;:;tJc? 7 <br /> <br />OWNER' S ADDRESS <br /> <br />L.. t1)OP <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIP'l'ION: LOT(S) BLOCK SUBDIVISION' <br />PARCEL LD.' /I/-~b ^ ,;)J- tJ/6c;-tJCJtJtV- ~-.?;;z 0 (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction ---..Addition ---...Alteration ---Repair _Install <br /> _Sign --IIove ->>e-olish <br />PROPOSED USE: ~iDgle Faaily --II/F _' of Units --II/H <br /> _ec-ercial _Indust. _Swia. Pool _Other <br /> <br />---Restaurant It Health Departaent Approval <br /> <br />DESCRIP'l'ION OF WORlC: COIUC-R.Er ~ -S//'ELJ - C;J,e,.q;;er- <br />Ii 1/ ,,/, ~r""'l- 9. r <br />BUILDING SIZE: //bxS'xl/Z ': -i!f"s Square Feet, rt:>.f"Height <br /> <br />RESIDENTIAL: ATrACB (2) PLOT PLANS It (2) SETS OF BUILDING PLANS It (1) SET ENERGY FORMS. <br />COMMERCIAL: ATrACB (3) SETS OF BUILDING PLANS It (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />-?S-oo. iJ () <br /> <br />Valuation of Total Construction <br /> <br />_ELECDUCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />----1IEClWlICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUKBIliG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY. ' <br /> <br />TYPE OF CONSTRUcnON: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FIlIISBED FLOOR ELEVAfiONS: <br /> <br />FT. <br /> <br />IS PROJECT IIi FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />BIJTTJlER <br /> <br />CONTRACTOR SECTION <br /> <br />~ L" "cOMPANY ,4cE /7Lt/;#, <br />I' Y __ State Cert. or Regist.' CleCL>~"" y~ ?D <br />~ "' City License Registration' c:P 3 <br />......................................*... <br /> <br />Signature <br /> <br />RT .RCTRICIAII <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration . <br />......................................**** <br /> <br />S10TUII ture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration f <br />....*....**.**.********..**....**.*.*****. <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration . <br />..............*..*...******.*.*******.**** <br /> <br />Signature <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />.............*.................*..**.*..** <br /> <br />APPUCATION APPIlllVED BY ~(/\)~ ID~ PERIIIT OFFICER. <br />