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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPIIYRlIILLS <br />BUILDING DEPAR1~ENT <br /> <br />M e. J" / n --r; J.... () r r- e.. Y"\ <br />OWNER'S AUDRESS .s y 13 '-I~' <br />JOB ADDRESS S If I 3 ~ fh ' <br />LEGAL DESCRIPTION: LOT(S) 1- if <br /> <br />OWNER'S NAME <br /> <br />~~Phyr~/IIS <br />:2.e P hv I( I..J//I~ <br />/ <br /> <br />1= J · <br />Fl. <br /> <br />BLOCK loJ I) <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D. t <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED: ____New Construction -^ddition ____Alteration ____Repair _Install <br /> ____Sign _Move _Demolish <br />PROPOSEI) USE: ____Single Family ____M/F - * of Units _M/H <br /> - Commercial - Indus t. _Swim. Pool _Other <br /> <br />____Restaurant & lIealth Department Approval <br /> <br />DESCRIPTION OP WORK: <br />(Jf 1.. ''I.'x I L' , <br />BUILDING SIZE: _~ __ <br /> <br />/ CJ 2... <br /> <br />Square Feet, ~. Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTAL11 (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 /> <br />AMP Service <br /> <br />Plorida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHANICAL <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 _FraJlle _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 />CONTRACTOR SECTION <br /> <br />BUILDER COKPANY <br />State Cert. or Regist. f <br />Signature City License Registration I <br />****************************************** <br /> <br />ELECTRICIAN COKPANY <br />State Cert. or Regist. # <br />SiRllature City License Registration , <br />****************************************** <br /> <br />PLUMBER COKPANY <br />State Cert. or Regist. . <br />Signature City License Registration , <br />****************************************** <br /> <br />MECHANICAL COKPANY <br />State Cert. or Regist. t <br />Signature City License Registration I <br />****************************************** <br /> <br />OTIIF.R COKPANY <br />State Cert. or Regist. t <br />Signature City License Registration # <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />