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<br />APPLICATION FOR PERKlT <br />CITY OF ZEPIIYRBILLS <br />BUILDING DEPARTHENT <br /> <br />f ' <br />?K;O'trU <br /> <br />OWNER'S IWtE ~E~~<<t Gf'l <)~e.:,h'c-JL/~. PHONE 6~ - b 702-- <br />OWNER'S ADDRas-Lt '6 S~ ~ \ " t S~. 17ct j) c.. C;\t-L, ~\. <br />\ <br /> <br />JOB ADDRESS (,r.. ~ I eh K (.J2e <; -\ (~) Drf 1 ? f(( h\j~ Vi.d \ <br />LEGAL DESCRIPTION: LOT(S) ~ BLOCK SUBDIVISION CC) <br />PARCEL IoD.' 0 - t?\ .- C,~otl ~c:c<.<.C , '-0080 <br />WORK PROPOSED: V'New Construction ---..Addition --Alteration --.Jtepair _Insta11 <br /> <br /> <br />_Sign <br /> <br />--1Iove <br /> <br />-1)eaolish <br /> <br />/ <br />PROPOSED USE: _Single Faaily <br /> <br />----.Jt/F _' of Units ----.Jt/H <br /> <br />_ec-ercial <br /> <br />_Iodust. _Swia. Pool _Other <br /> <br />Restaurant Ii: Health Departaent Approval <br /> <br />DESCRIPTIOB OF WORK: (1'\0 i) (,,\ ~ (:, (1\ e- <br /> <br />BUILDING SIZE: 5(/ X 5;)',1, ~~C)'S Square Feet, 9.lllf II Height <br /> <br />RESIDEIITIAL: ATTACH (2) PLOT PLABS Ii: (2) SETS OF BUILDING PLANS Ii: (1) SET BRBRGY FORHS. <br />COMKERCIAL: ATTACH (3) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FORHS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />LaUlLDING <br />t/ RI.I~cnuCAL <br />-LJmCIIANICAL <br />-LPLUKBING <br /> <br />$ &~ 9~;/O, ('; () <br />, <br /> <br />Valuation of Total Construction <br /> <br />?\o~ <br /> <br />AIIP Service <br /> <br />V' Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <^'1' \i () <br /> <br />Valuation of tlecbanica1 Insta1lation <br /> <br />GAS <br /> <br />V ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF mBSTllucnoB: -block _Fraae _Steel <br /> <br />Other <br /> <br />FIBISBED FLOOR. ELEVAnOBS: <br /> <br />Fl. <br /> <br />IS PROJECl IB FLOOD ZONE AREA? <br /> <br />/' <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />COBTRACfOR SECTION' <br />rl ,", n ,- <br />BUTT.DER ~ t\~ Ire COtIPANY C~~~'HCUt+ "-6N~(I.,t~~ ,~c:. / <br />(~ .ovcr-' ' State Cert. or Regist.' f-...~ ~j(~ V <br />Signature ')..j ~ City License Registration' 1/7 <br />/ <br />~~,......~......~.~...:....:......:~.~ " \' <br /> <br />3~ P ~HPANY -r&r(rf' IlL~i' /'YIkrh},j ~/~ / <br />" , State Cert. or Regist.' El"l..,ptT { l. l..ll V <br />SilmJlture City License Registration' <? Ii f ' <br />.......................................... <br /> <br /> <br />PL_ ~ COHPAIIY (; P lAm loll'! <br />~ State Cert. or haist. f <br />Signature ' City License Registration . <br />......... . ............................ <br /> <br />IIBCllANICAL ~',\.. , COMPANY S' a:..FT r\E,<.....\,.. C C }-L- -f-' C'" \' E ~\ / <br />J. .A V <br />. "/ State Cert. or Regist.' ,:z fv\.80 J ~ G d-;,.)- <br />Siaoature J . 1L.-1Z,_~ City Licease _iB~atiOD f S"' '~o"" ~~!.....~ <br />.......................................... <br /> <br /> <br /> <br />OTIIRR.. ~ COHPAIIY ~f<3~.ct Q"',,-{fU.C+.'''''' S-i<.<:', <br />- ~;;;1 , " State Cert. or Regist.' Rf!, C' ()~ , c:- R'-3 <br />Signature ' ~ '- - \ City License Registration' } /1 <br />' '.......... ............................... <br /> <br />APPLICAnON APPROVED BY <br /> <br />PBRHIT OFFICER. <br />