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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPllYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAKE (J''-tJI-4e::--- /J/O-S<;O/Y? If'OAJcJ. /'~/v4 PHONE 7Yff~ Ot:JO/ <br />/ <br /> <br />OWNER t S ADDRESS V t:. / ~ /34:) 3.)(' ~)1 g)j,/ c( :z..tP a AI. /X .J J ~ '7/"/ <br />,. ,r <br /> <br />JOB ADDRESS '/, (J 6 .lJ/o...s oS /) ""1 fJ /cf *' ...1 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D"' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />..., . <br /> <br />WORK PROPOSED:_New Construction _Addition --Alteration --KRepair _Install <br /> ~ <br /> _Sign _Hove _DeJIOlish <br /> . ~H/F <br />PROPOSED USE: _Single F8IIily _' of Units _H/H <br /> ,~ <br /> _~ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant &: Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />);XClO Square Feet, /V 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 />_'BUILDING <br /> <br />$ .:;-:] 5/0 tjf:1 <br /> <br />PERMITS REOUESTEq <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 />_MECllAlfICAL <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />X ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT" <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />Bml.DER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />RT.RCTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />SiRnAture <br /> <br />PLUMBq <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />,MECHANICAl. <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />OTRF.R I?oo /,.... 7- <br /> <br />COMPANY Jo~Ji J6we II 11j//J )GvIN 1/; "rOt' I;', "'/ <br />State Cert. or Regist. , li'c ()();( ,c:S/S"" <br />City License Registration # &' fJ 0 <br />.......................................... <br /> <br /> <br />Signature " <br /> <br />PERMIT OFFICER. <br />