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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPIIYRlIlLLS <br />BUILDING DEPARTMENT <br /> <br />,I <br /> <br />OWNER'S NAME Ve1o..: F~A-Nk rf L 1/11 M S <br />OWNER'S AUDRESS / fer C ( If () e y I Lf -R. J. Grl1 ~- p Pc> / A.J f.(~ <br />JOB ADDRESS .3 rgt/Q./ C R C; if Z-eP~l" L 1/<:; <br /> <br />PHONE <br /> <br />fh~ 'f fJ. ~ 0 <br />::;L <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL I.D.# a.d. ~(p;)/ tJ()(O o~ao6 <br /> <br />BWCK <br />C)C>OlO <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED:____New Construction ----Addition <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br />IJ. ~ Roof <br />____Alteration ~Repair ____Install <br /> <br />____Sign <br /> <br />____Move <br /> <br />____Demolish <br /> <br />PROPOSED USE: ____Single Family <br />~COIN8ercial <br /> <br />____M/F <br /> <br />____, of Units ____M/8 <br /> <br />____Indust. <br /> <br />____Swim. Pool _Other <br /> <br />____Restaurant & lIealth Department Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />R-fi!.. ,(,'00 .c <br /> <br />Square Feet, <br /> <br />Height <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PWT 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 />-.ELELJRICAL <br /> <br />AMP Service <br /> <br />Florida 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 ____FrUle ____Steel <br /> <br />Other <br /> <br />FINISIIED 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 <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration # <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />Sia.na.ture <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration t <br />****************************************** <br /> <br />PLUKBER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration t <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. I <br />City License Registration t <br />****************************************** <br /> <br />OTIIF.R <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration , <br />...................................1...it..~. ...-.~...~..";,-;,;::;.~~]...~...,:.. ...... <br /> <br />f ~;i_'T>F ~' <br /> <br />...,~"""..c..~ ~1l/MI_l..-;~........ . _ _ -.c.,! <br /> <br />APPLICATION APPROVED BY <br />