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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPllYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAKE O<:::Q. ~ ~V--) PHONE "7'1: 0 .-; ~ X-?- <br />OWNER'S ADDRESS ~ ')()Ll) r ,\L \)r (. ~ <br />JOB ADDRESS ?) c; 0 ':d <J r Q d- Dc ( '(;C': <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br /> <br />PARCEL LD.' <br /> <br />(OBTAIN FROK PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Kove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_KIF <br /> <br />_' of Units _K/H <br /> <br />_~ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Department Approval <br />DESCRIPTION OF WORK: L'tUo..O (' ,\--a'l<7 O~ (}..-\vn ~1i.:tA--\( ~~~ <br />BUILDING SIZE: X Square Feet, Height <br /> <br />) O~..- <br />1 j;J- t:-~'-.J <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 />_ELECTRICAL <br />~CHAlUCAL <br /> <br />AMP Serv'ice <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ 1 aL\Co ,00 <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUcnON: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />r <br /> <br />CONTRACTOR SECTION <br /> <br />BUTI.DER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration f <br />****************************************** <br /> <br />Signature <br /> <br />RT.RCTRICIAR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************.....***********.......... <br /> <br />SionAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />........**...*........*****...*.....*..... <br /> <br /> <br />-.IC6L ~ ~ .~ <br />Signature \' \, u~ <br /> <br />Signature <br /> <br />.. <br /> <br />COMPANY C. au \ k5 ~ ft~P~(-l ~ C\- 4/ L.. <br />State Cert. or Regist. . q CQ...~(.q 7\1. <] <br />City License Registration . <br />...*........*..*...**......**............. <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration , <br />.*.*..*..*.*......*........*...*.*.....*.. <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />