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<br />APPLICATION FOR PERMIT <br />CI TY OF ZEPIIYRlIlLLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME fp. 112. <br />OWNER'S AIJORESS ,') g II <br />JOB ADDRESS 6~ I / <br /> <br />H (fSS AI{ FJ /l./N <br />F (({51 _ ~1/2.. <br />rl/2.S1 ~1~1 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PHONE 7;7'.- (!) :3 gO <br />Z /3. P HY fJ.. H II.~L5 <br />Z If. fJ Hf/ p.. HI J..L5 <br />~,;; <br />SUBDIVISION ~~2 <br /> <br />PARCEL LO.t <br /> <br /> <br />WORK PROPOSEIJ: ____New Construction -^ddition ----^lteration _Repair <br /> _Sign ----"ove _Demolish <br />PROPOSED USE: _Single Family ----"I F ---- # of Units _M/D <br /> _Connercial - Indus t . _Swim. Pool _Other <br /> <br />____Restaurant & lIeaIth lJepartment Approval <br /> <br />DESCRIPTION OF WORK: <br />BUILDING SIZE: ~xL. . ..2 ?JJ <br /> <br />Square Feet. g:> ~ <br /> <br />lIeight <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 />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />~LEL'TRIGAL <br /> <br />AMP Service <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />SPECIALTY <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />TYPE OF CONSTRUCTION: ~lock ____Fr88le _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? L <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration t <br />.............................*.*.........* <br /> <br /> <br />ELECTRICIAN COMPANY <br />State Cert. or Regist. # <br />SiROature City License Registration t <br />............*...........*..........*...... <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration # <br />*.*.........*.*.*...........*............. <br /> <br />KECBANICAL COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration t <br />.......................................... <br /> <br />OTHF.R COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration t <br />.......................................... <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />