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<br />)},/' fi-1 J <br /> <br />APPLICATION FOR PRRHIT <br />CITY OF ZEPIlYlUllLLS <br />lHJ1LDl.NG DEPAIrfM.ENT <br /> <br />lOT <br />OWNER IS NAMB <br /> <br />8.c CVn .s....t:...<?~0..-___..___________..~__~_PHONE <br />LOT (p S- <br /> <br />~e.J'~ \ d <br /> <br />OWNER I S ADDRESS <br /> <br />....~..__.~.--_._--.---....~..--..--........-... <br /> <br />JOB ADDRESS <br /> <br />P t::> i V\ -\- <: <br /> <br />~ V ~V't- <br /> <br />LEGAL DESCRIPTION: LOT(5) <br /> <br />nLOC~___SUBDIV1SION <br /> <br />PARCEL 1.0.' <br /> <br />(OBTAIH-ERQ~~QP~~TY ~ ~QjICE) <br /> <br />WORK PROPOSED:_New Construction _~Addition _Alteration ~cpair _Install <br /> <br />_Sign <br /> <br />--1tove <br /> <br />_OemoHsh <br /> <br />.. <br />. <br /> <br />PROPOSED USE: ____Single Family <br /> <br />--11/ F <br /> <br />_, of UnHs <br /> <br />MIa <br /> <br />_CQn'l1llaerda.l <br /> <br />_lndust. <br /> <br />_Swilll. Pool <br /> <br />_Oeller <br /> <br />_Rest3ut'ant &: Health Depart.ment Approval <br /> <br />DESCRIPTION OF WORK:~__~__ <br /> <br />BUILDING SIZE: ~_~_' <br /> <br />_Square Feet,_______Height <br /> <br />RESiDENTIAL: <br />COMMERCIAL ; <br /> <br />ATTACH (2) Fl..OT l>LANS lie (2) SInS OF l:WILl>lNC Pl.ANS lie (1) S~1' ENERGY FORMS. <br />ATTACH (3) SETS OF a~ILDING PLANS & (1) SET ENERGY FO~~. <br />PROPt:RTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. . <br /> <br />f~Rtl.;;.t~LRe.Q.IJt~.r.f& <br /> <br />_BUILDING <br />~ELEC'TRlCAL <br />-HECHANICAL <br /> <br />$---.... . <br /> <br />. ..Valuation of Total Construction <br /> <br />__1 O~AtfP Service <br /> <br />~__....._Flodda Power Corp. <br /> <br />_W.R.E.C. <br /> <br />$ <br /> <br />Valulltiou ()( Hec::ha.nical Installation <br /> <br />_PLUMBING <br /> <br />~~~GAS <br /> <br />+__.__ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Pralle _Steel <br /> <br />_Other <br /> <br />f'INISIiE.D FLOoR ELEVATIONS: <br /> <br />Ft. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />******t*.**...........,......**.*.*...*..* <br /> <br />CONTRACTOR SECTION <br /> <br />IWI~ <br /> <br />COH...PANY <br />State Cert. or Regist. t <br />City License RegistratioQ t <br />....*****.......*.*.****............**..*- <br /> <br />Signature <br /> <br />~~ ~~ COMPANY'/.. tJa. CZVz/ r e-4f <br />. ., /' _/ (~,,) ~ I'" S~ate Cert. or Reglst. IJ....-J~ 0.. "0(>.6 Ii <br />SiJUlature X. .~,... J. ~?~ Cl.ty License Registration # ) ~ '] <br />*t*t*.*'...*t...**............**...,_*_... <br /> <br />~1r~ <br /> <br />COHPANY_ <br />State Cert. or Regist. , <br />City License Registration # <br />.......*........**...*.................... <br /> <br />Signature <br /> <br />l'.l&~ <br /> <br />Signature <br /> <br />COHPANY_~_~_~ <br />State Cer.t. or Regist. ~____ <br />~~-- City License Registration' <br />.****.*.***~*...****..*.*..**A.**..*..*.*. <br /> <br />Q.lJlER <br /> <br />COMPANY__ <br />State Cert. or Regist. ~ <br />City License Registration t <br />.***ttt..*...**...**,**.***.****,.......*. <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY _~~ <br /> <br />-, <br /> <br />PERMIT OFFICER. <br />