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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPllYRBILLS <br />BUILDING DEPARTMENT <br /> <br />,. . <br /> <br />OWNER'S NAH8 <br />OWNER'S ADDRESS ') <br />JOB ADDRESS 5...,. /1'7 e <br /> <br />Ie e /l O'v <br />~ )-)- 7 <br /> <br />e/l <br />130(<.. <br />/7'./ fft!I'?V-€... <br /> <br />WOc?-7/ 1/ ,r, <br /> <br />PRONE 'J?j~ - ~c b :Y <br />2e /?/; 'I~-<'//5 ~_ <br />/ <br /> <br />~ <br /> <br />LEGAL DESGRlPTION: LOT(S) <br /> <br />B~SUBDIVISION <br /> <br />PARCEL I. D.' (\lITAlB fROM l'8OPRRTV TAlI lIOIICU <br />WORK PROPosJm:_New CoustrucUon _AddiUon ~t.rauon --..B....ir _Install <br /> <br />_Sign <br /> <br />-Hove <br /> <br />_DeJIOlish <br /> <br />PROPOSED USE: ~ingle Fallily <br /> <br />_H/F <br /> <br />-' of Units _HIH <br /> <br />_eo..ercial <br /> <br />_Indust. <br /> <br />_Swu.. Pool _Other <br /> <br />DESGlUPTION OF WORK: <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />f( e ~/7C e <br /> <br />I <br /> <br />II e 4 -f ,C (/~ ,LJ. <br /> <br />, I <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 />_BUILDING <br /> <br />PERMTTS REOUE..<;TEQ <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />-~G'l'RICAL <br />~CllAlUCAL <br /> <br />AMP Service Florida Power Corp. <br />)- ,:7 J--)-- Valuation of Hechanical Installation <br />/ <br /> <br />H.R.E.C. <br /> <br />$ <br /> <br />_PL~ING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />FDIsBED FLOoR ELEVATIONS: <br /> <br />TYPE OF CONSTRUCTION: _Block _Fralle _Steel <br /> <br />Other <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />/. <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />BUJ:I.D~ <br /> <br />CONTRACTOR SECTIOli <br /> <br />Signature <br /> <br />GOKPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.......................................*.. <br /> <br />EI.RGTRTCIQ <br /> <br />SiQqAture <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration . <br />........*....*.*..*.***..........**.*.*.*. <br /> <br />PLUHBQ <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration I <br />*...........*..*..*..*..........*...*****. <br /> <br />.. <br /> <br />tlECRANlGA~ . <br />/. <br />Signature ~ <br /> <br /> <br />COIIPANYr>' '" <7 v · ~' , '(",,.,d',!; ,'" ' lie, I)" f <br />State Cert. or Regist. # L 0 ,-> ? J / <br />City License Registration I ~ / - c ~ cO S"'i ? '3 <br />.*.......*..**.......*.*......*****.***.** <br /> <br />mmB <br /> <br />Hgnature <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.*.....................*.........****..*.. <br /> <br />lPPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />