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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBILI..S <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAKE A(Z..(S :2r A--\-A-~ <br />OWNER'S ADDRESS Co:J..4L:, ~ ~<;. <br />JOB ADDRESS ts:,~4-<.o ~ ~K<;. <br /> <br />PHONE " ~ :s-- \ to 9./3 <br /> <br />B(oo <br />BQoo <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL loD.' 3' 'J. <0 - d.- \ . C) \'20 ". bOOOO <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition ~eration _Repair _Install <br /> _Sign -.-Move _Deaolish <br />PROPOSED USE: ~e Faaily -.-MI F _' of Units _M/H <br /> _<=<-ercial _Indust. _Swim. Pool _Other <br /> <br />_Restaurant &: Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: - P N\.eS2.A->i. j) <br /> <br />~ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <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 />~LDlNG <br />~CTRICAL <br /> <br />$ <br /> <br />/)~ <br />ZZCD <br /> <br />PERMITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECllAlUCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUcnON: _Block ~aae _Steel <br /> <br />Other <br /> <br />FIlfiSHED FLOOR ELEVAITONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />Signature <br /> <br />~~ <br /> <br />CONTRACTOR SECTION <br /> <br />. COMPANY ~ 'j M.~ ~ So kA.ALJL1t1N <br />~ State Cert. or Regist. . e~c .035 \ 34- <br />v-- City License Registration' ~f <; "" <br />* **************************************** <br /> <br />BUn.DER <br /> <br />~ ~ COHPAtlY_~f..~ S "'<+=:~ <br />~ State Cer<. or Regist. # b:. 1"--00\ ~~ <br />......... -City License Registration # 11 ~ l <br />*** *********************************** . <br /> <br />PLUMBER <br /> <br />f\:) / A- <br /> <br />I <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />ftJ/ A <br /> <br />, <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />OTHER <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />APPLlCAnON APPROVED BY~ ~_ <br /> <br />rJfA <br /> <br />, <br /> <br />Signature <br /> <br />PERMIT OFFICER. <br />