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<br />APPLICAnON FOR PERKIT <br />CITY OF ZEPIIY1UIILLS <br />BUILDING DEPAR'l'HENT <br /> <br />OWNER'S IWIB If. C\ a. .\='~-\-""2.- '~*~i cK <br /> <br />OWER'S ADDuss-11 t( - ~ S t - <br />JO~ ADDRESS -z.e. fhJv h ~ ~\ 'S I ~l. <br /> <br />LEGAL DESCRIP'1'ION: LOT(S) BLOCK SUBDIVISION <br />PARCEL I.D.' }4""~~- J..J-OO/V-o3<ioo ~OO~O (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:__ew Construction ---..Addition Dtteration ---...Repair _Install <br /> <br />PHONE <br /> <br />_Sign <br /> <br />-.JIove <br /> <br />--PeIIolish <br /> <br />PROPOSED USE: V'~iDa1e Feally <br /> <br />---Jt/F _, of Units ---Jt/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swill. Pool _Other <br /> <br />Rea~t " Bea1th .Depar-..t Approval <br />DESCRIPnON OF won: I €Ih 010 VtC +-1 (}l.L -S <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATrACII (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET DERGY FORKS. <br />COMKERCIAL: ATTACII (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />-BUILDING <br /> <br />$ <br /> <br />PERMITS REQUESTED <br />2. t 1 ~~). a-i) Valuation of Total Construction <br /> <br />RT -EC'l"RICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />V.R.E.C. <br /> <br />---.JIECIWIICAL <br />-PLUHBIIIG <br /> <br />$ <br /> <br />Valuation of lIechanica1 Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSDUcnON: ---Block _Fraae _Steel <br /> <br />Other <br /> <br />FIIIISIIBD PI.OO1I. BLEVAnONS: <br /> <br />FT. <br /> <br />IS PROJECT III FLOOD ZONE AREA' <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION' <br /> <br />IIIJT1BII . . at/ COHPANY ~J3JktRt GI'ISI-n,-<-tJ,-C/;.! Be, <br />State Cert. or Regist. . Kf.-< ()(Jd/<SK3 <br />SiBD8~ [ _ '-' City License Registration' ;1 '1 <br /> <br />=. ~ COIIPAIIY KOG'Ce<; ~\eC*i\c. <br />State Cert. or Regist. fE..~O(lIZZZ1 <br />e City License Registration . ..;;.. (, q <br />, <br />.......................... .............. <br /> <br />PLIDIBER COHPANY L{S~ ij?\LlY1\0tN b <br /> <br />~ q~. State Cert. or Ile&tst. t ' <br />Sl8D8ture ~J)J;).1 City License Registration , {'" {.. .... <br />......... .............................. <br /> <br />~- <br /> <br />...,- <br /> <br /> <br />v <br /> <br />BmIWITCAL L &.-.. COIIPAIIY 0 '-'L/ ~ <br />State Cert. or Regist. , <br />Sigoature,) City License Registration' <br />- ~ .......................................... <br /> <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registrati~' <br />.~...............................*...~.... <br /> <br />Sigoature <br /> <br />;.; . "", . ":I". .. <br />~.'~',;: <br /> <br />APPLICAnON APPROVED BY <br /> <br />-. <br />PERKIT OFFICER. <br />