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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPIlYRlIlLLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME WHJt'K- (t) 8~Ak.,LJi Oo~J PHONE 7~v - '}08t <br />OWNER'S AUDRESS &'6'10 ~k~)A."'J f'~ I 2-0/1.,/11/'-,1;$ I j/J.~,;/<. :l1S1.fI <br />~9>'-ID Sf-cl'~ PIL I Z"'i.J"J.~~l,lls I ~~,J... J1S-fl <br />, I t <br />SUBDIVISION '5/liHh ()~ <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL 1.0.# Ol-1.t:,-2/-olfgO -DDooo-01&)D <br />WORK PROPOSED:_New ConstrucLioll ~dition <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />_Alteration _Repair ____Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Delllolish <br /> <br />PROPOSED USE: ~Single Family <br /> <br />_M/F <br /> <br />_# of Units _M/H <br /> <br />_Connercial <br /> <br />_Indust. <br /> <br />_Swim. Pool _Other <br /> <br />BUILDING SIZE: <br /> <br />Restaurant & Health Department <br /> <br />(l~~()c1-i-l ~ <br />Jt) X J7, {10 <br /> <br />Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />Square Feet, <br /> <br />171 PI...~ LA..... <br />o Height <br /> <br />RESIDENTIAL: <br />COtu1ERCIAL : <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 />~UILDING <br />~LEGTRICAL <br />LECIIJ\NICAL <br /> <br />PERMITS REOUESTED <br /> <br />$ /B/ (Ji>O - <br /> <br />/-t;;/J NIP Secvice <br />$ 300 -- <br /> <br />Valuation of Total Construction <br /> <br />~Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />Valuation of Mechanical Installation <br /> <br />~LUMBING GAS ~ ROOFING SPECIALTY <br /> <br />TYPE OP CONSTRUCTION: KBlock _PrOle _Steel <br />y~, ~~h~ <br />FINISHED FLOOR ELEVATIONS: 0" FT. IS PROJECT IN FLOOD ZONE AREA? <br /> <br />Other <br /> <br />YES <br /> <br />2( <br />NO <br /> <br />.......................................... <br /> <br />BUILDER <br /> <br /> <br />CONTRACTOR SECTION <br />. COMPANY (j;1) IZ- t.lv-~/.-^'I ~ ~ <br />/ ,j) Y1A State Cert. or Regist. f <br />fVl{/~ Itf1'- City License Registration * ~ yrs- <br />.......................................... <br /> <br />Signature <br /> <br />Sia,nature <br /> <br />x <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration # <br />.......................................... <br /> <br />IJ'~ <br /> <br />$I-~jv,~- <br /> <br />ELECTRICIAN <br /> <br />'l'f <br /> <br />PLUMBER ~ ~ COMPANY <br />State Cert. <br />Signature. City Licens gistration f <br />.......................................... <br /> <br /> <br />Signature <br /> <br />lJ. COMPANY <br />State Cert. or Regist. # <br />X:, ~ ffi,,?? J.J;; City License Registration . <br />........... *............................ <br /> <br />MECHANICAL <br /> <br />c2of.:::> <br /> <br />OTHF.R <br />Signature X <br /> <br /> <br />COMPANY tJ--1 !Zv~/~ J~' <br />, <br />State Cert. or Regist. # <br />City License Registration # <br />.*......*.......*......................... <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />