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<br />APPLICAnON FOR PERKIT <br />CITY OF ZEPIIYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER I S ADDRESS <br /> <br />~()S~fZ 1 <br />SO;? l' <br />S~mL <br /> <br />8UCl1ELii: <br />/tzt:!- -r-r-, <br /> <br />PHONE <br /> <br />7ftJ-/r2~5 <br /> <br />OWNER 's RAKE <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION' <br />PARCEL I.D.I (/-,d,b-d /.-. 019/0 - ..::>/a DO - t1 io~~fFROK PROPERTY TAX NOTICE) <br />WORK PROPOSED: ' V-:ew Construction ---..Addition ----..Alteration --.Jlepair _Install <br /> <br />_Sign <br /> <br />---.Jfove <br /> <br />_DeIIOlish <br /> <br />pmPOSED~E: ~~eF_i~ <br /> <br />---.Jf/F _' of Units ---.Jf/H <br /> <br />_ec-ercial <br /> <br />_lDdust. _Swia. Pool _Other <br /> <br />--Restaurant (( Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: t AIL Pc> f{. 'f <br />BUILDING SIZE: J'I' X /'1/. ~h Square Feet. <br /> <br />. / <br />, rO J' Height <br /> <br />RESIDEBTIAL: ATTACH (2) PLOT PLANS (( (2) SETS OF BUILDING PLANS (( (1) SET ENERGY FORMS. <br />COItKERCIAL: ATTACH (3) SETS OF BUILDING PLANS (( (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />V:UILDING <br /> <br />PERKITS REOUESTED <br /> <br />$ <br /> <br />f??;-o <br /> <br />Valuation of Total Construction <br /> <br />Rl.ECTRICAL <br /> <br />AHP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />----1tEGllAllICAL <br /> <br />$ <br /> <br />Valuation of tlecbanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY, . <br /> <br />TYPE OF CORSTRUcnON: _Block _Fr_e _Steel <br /> <br />Other <br /> <br />F1IUSHED FLOOR. ELEVAnORS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CORTRACTOR SECTION <br /> <br />Signature <br /> <br />~~~,.. .. ;', . . cOtIPARY ..4CE ,lfLt/J0, <br />- State Cert. or Regist.' C~6./J s'/k? <br />City License Registration . ~~ <br />..............*..*.......*..**...********. <br /> <br />BUTl.DER. <br /> <br />F.T .RGTRIGIAR <br /> <br />COMPANY <br />State Cert. or Regist. I <br />City License Registration . <br />********.******************.**.**********. <br /> <br />Sionature <br /> <br />PLUKBER <br /> <br />GOKPAtlY <br />State Cert. or Regist. , <br />City License Registration , <br />**.***..*.*********************.********** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration f <br />*******************.********************** <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />**.**.**.*.****.****.****.**************** <br /> <br />Signature <br /> <br />APPLICATION AP~VED BY <br /> <br />PERHIT OFFICER. <br />