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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPIIYRlIILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER · S NAME ~ <br /> <br />Rv8J;f(J <br />v <br /> <br />.S 6 Z CJ <br />___ c;-- p .rn <br /> <br />f> K r;;- <br />,ST <br /> <br />PHONE <br /> <br />~82 - 829'Y <br /> <br />OWNER · S ADDRESS <br /> <br />/97# <br />..--- <br />r: <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1.D.' <br />WORK PROPOSED: ~ew Construction <br /> <br />~ition <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />----Alteration ____Repair ____Install <br /> <br />____Sign <br /> <br /> <br />PROPOSED USE: "/Single Family <br /> <br />_Move <br /> <br />____Demolish <br /> <br />____M/F <br /> <br />____, of Units ____MIll <br /> <br />____CORIIeccial <br /> <br />____Indust. <br /> <br />____Swim. Pool ___Other <br /> <br />____Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />WORK: I~X /8 <br />;<7 X /8 , <br /> <br />c 171{ tPo~-r <br /> <br />DESCRIPTION OF <br /> <br />Square Feet, <br /> <br />lIeight <br /> <br />RESIDENTIAL: <br />COMMERCIAL <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. .. <br /> <br />PERMITS REOUESTED <br /> <br />~~UILDING <br /> <br />$ <br /> <br />;z9CCJ. (2 C? <br /> <br />Valuation of Total Construction <br /> <br />____ELECTRICAL <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 />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />BUlIDER <br /> <br /> <br />CONTRACTOR SECTION <br /> <br />ottPANY ;=J \J Is C D /l-.6' T- <br />State Cert. or Regist.' C I? C 033"7' L I <br />City License Registration' / i./ 7" <br />, <br />***************...*..**..***....**.* <br /> <br />Signature <br /> <br />ELECTRICIAH <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration # <br />*..******.****..***********.****.*.*****.* <br /> <br />SiRlUlture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration . <br />*****************************.************ <br /> <br />Signature <br /> <br />KECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration t <br />*****.******~***************************** <br /> <br />Signature <br /> <br />omF.R <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration' <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />