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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPIIYRlIILLS <br />BITILDING DEPARTMENT <br /> <br />lj_ f f C 'f 7 <br /> <br />OWNER'S NAHR ' <br /> <br />GfZ-4N c{ <br /> <br />1/ 0 IL / '2.-0;'I..J S <br /> <br />PHONE <br /> <br />7.P..z-/~6b <br /> <br />OWNER'S ADDRESS <br /> <br />p. 0, ;Joy::.. /~r/ <br /> <br />?-f({(I,.> 3 y~)? - /,rcf' '7 <br /> <br />JOB ADDRESS <br /> <br />7' t if!:>- 6" ,z-d ~ /V .>Lc ~e: -<.J /2- <br /> <br />z - /-f,,//5 <br /> <br />LEGAL DESCRIPTION: LOT(S) / ;2- BLOCK SUBDIVISION <br />PARCEL I.D.' 3' L(c... '2 ~-- ;?( - <::) 0/0 .- 6 / :5 60 .- / l.- (oBTAIN <br /> <br />("r/Z-Pr~ cf 1-/0 /Z-/ 2-;,v S <br />FROM PROPERT~ TAX NOTICEl <br /> <br />WORK PROPOSED:_New Construction -4S-Addition _Alteration <br /> <br />_Repair - _Install <br /> <br /> _Sign _Move _Demolish <br />PROPOSED USE: _Single Family _M/F _, of Units -$IH <br /> _COIIBercial _Indust. _Swim. Pool _Other <br /> _Restaurant & lIealth Department Approval <br /> <br />DESCRIPTION OF WORK: e 0 tV C /t.. rZ 7€ . / t/ tf' Y'" PA j. ,; <br />BUILDING SIZE: /'2- L X ~ 1-. rf'oo Square Feet. ~;)/ Height <br /> <br /> <br />RESIDENTIAL: <br />COHHERCIAL <br /> <br />ATTAClI (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~UILDING <br /> <br />$ <br /> <br />PERMITS REOUESTED <br /><.. "L0 C) ., 0 5!-- <br />I Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.c. <br /> <br />_HECHAIUGAL <br /> <br />$ <br /> <br />Valuation of HeCltanical Installation <br /> <br />_PLUMBING GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br />fJ 1 U M I ,uj,/~ther <br /> <br />TYPE OF CONSTRUCTION: _Block. <br /> <br />_FrUle _Steel <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? -X <br />YES NO <br /> <br />..**......***.**..*..*.*.*..************** <br /> <br />BUILDIm <br /> <br />CONTRACTOR SECTION <br /> <br />COMPANY ..,~ -yo- r-1 '1 ~ :-:-:> ~ <br />~ ~'~.:" State Cert. or Regist. , <br />7- J ~ City License Registration I <br />*******.******************.*************** <br /> <br /> <br />~~ <br /> <br />, <br />Signature <br /> <br />ELECTRIC~ <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />**.**..*********************************** <br /> <br />SifUlature <br /> <br />PLUMBER <br /> <br />COMPANY <br />St~te Cert. or Reg!st. , <br />City License Registration , <br />**********************.***.*.........*..** <br /> <br />Signature <br /> <br />tlEGHANI~ <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registratioi' , <br />************~.**************************** <br /> <br />Signature <br /> <br />OTIIER <br /> <br />~ r-::--. ....... <br />~..'COIIPA.Y /77/ffR'/< r;-y-(<<",/o.< <br />Q / State Cer<. 0.. Regist. '_ P)( "0 "fl' fr/j'- <br />- CU;y L.icense Registration / ~ L <br />. *.****************************...********- <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />JilT OFFICER. <br />