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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPIIYRlIlLLS <br />BUILDING DEPARTMENT <br /> <br />.- CJ-V <br /><fl? r 70>... <br />1-1 'l-7~ <br /> <br />JOB ADDRESS <br /> <br />~71'L <br /> <br />JOk,,- li:1 v.v'7;"'4- ~ PIIONE <br />C, "23(. ;]:n,J.-wt"- S;f" '2~/'-i.~i;-I7$ I f!I~/.24l- <br />MtllL ~ f)/~ 2~1,rt,[ 15'~ 11~;2" <br />1-; BLOCK JJ:.. SUBDIVISION SJ,..A.v"~Ck-ll,d <br /> <br />OWNER'S NAME <br /> <br />OWNER'S AODRESS <br /> <br />.f3 J"ttD <br />:1 SrY / <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL 1.0.' O~ -2"..... 2/- o/JO <br />WORK PROPOSED:~ew Construction <br /> <br />... O{)ulJiJ - tJ/7 D <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />_Addition <br /> <br />_Alteration <br /> <br />_Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Demolish <br /> <br />PROPOSED USE: ~Single Family <br /> <br />_M/F _# of Units _M/8 <br /> <br />_Collllllercial <br /> <br />_Indust. _Swim. Pool _Other <br /> <br />_Restaurant & lIealth Department Approval <br /> <br />DESCRIPTION OP WORK, . >")1.... If-), ('..JJ.~ /f--- <br />n'-'u II l) "/" 1 'b D <Q I ~/~ (;,~ <br />BUILDING SIZE: VJ I X V ,vD Square Feet, () 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 />XBUILDING <br />XELEL"TRICAL <br />~MECHANICAL <br />,.k;LUMBING <br /> <br />$ t~ Ouu --- <br />/5D <br />3/vD-- <br /> <br />PERMITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br />~ ROOFING SPECIALTY <br /> <br />GAS <br />TYPE OF CONSTRUCTION: XBIOCk <br />FINISHED FLOOR ELEVATIONS: i, i' FT. <br /> <br />_FrUle <br /> <br />_Steel <br /> <br />Other <br /> <br />YES <br /> <br />X <br />NO <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />BUILDER <br /> <br /> <br />CONTRACTOR SECTION '_ . . t . . <br /> <br />COMPANY lJi 1J Il- V'W~ I ~ <br />ivll/,~tI;;i State Cert. or Regist.' C/U. b S- '/~71 <br />City License Registration f ~~ <br />****************************************** <br /> <br />Signature <br /> <br />Signature <br /> <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration t <br />****************************************** <br /> <br />) n COMPANY 4,,"''1/ J. ff~ <br />7 g~ State Cert. or Reglst.' ~ "0/21>1'&0 <br />~ ,----- City License Registration , 9/ <br />*****************.*****..********.******** <br /> <br />COMPANY S~ . j ,tZ vWW/.- 'JIII;~ <br />State Cert. or Regist. # <br />City License Registration t <br />*****************.*********************. <br /> <br />~~ <br /> <br /> <br />t:x:> <br /> <br />=:~~ f)~6 <br /> <br />PLUMBER <br /> <br />Signature <br /> <br /> <br />'{lJh. eoo l~/ <br />llJ...- "0 iw" ( <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />COMPANY /rll7v..~ J~. <br />State Cert. or Regist. t' rU ()()(,/ Y'~ <br />City License Registration I ~~ <br />***.**..***.*********.******************.* <br /> <br />2IIIER <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />