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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPIIYIUI1LLS <br />BUILDING DEPARTMENT <br /> <br />OWNER' S _ 7C!) J Ij /! c... <br />I f-" <br />OWNER'S ADDRESS ~ 93;;( / ~ 1+ (/ <- <br />JOB ADDRESS S .4-/11 c <br /> <br />PHONE <br /> <br />778'-{)3f).9 <br /> <br />LEGAL DESCRIPTIOR: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' tJ -)c:, -d I, () 5//) ...()()()OO - (),s /0 <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_Rew Construction _Addition _Alteration ~epair _Install <br /> <br />_Sign <br /> <br />--1Iove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single FUlily <br /> <br />_M/F <br /> <br />_, of Units _K/H <br /> <br />_~ercial <br /> <br />_lndust. <br /> <br />_Swill. Pool _Other <br /> <br />DESCRIPTION OF WORK: <br /> <br />/It) () <br /> <br />& Health Departaent Approval <br /> <br />j)rlUc. {))/fV <br />( <br /> <br />77J <br /> <br />g/ f.-. .J S I <br /> <br />_Restaurant <br /> <br />BUlLDIRG SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDERTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLARS & (2) SETS OF BUlLDIRG PLANS & (1) SET ERERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ERERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDIRG <br /> <br />$ <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 />~CBARlCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBIRG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CORSTRUCTIOR: _Block _FrUle _Steel <br /> <br />Other <br /> <br />FIRI.SBED FLOOR ELEVATIORS: <br /> <br />Fr. <br /> <br />IS PROJECT IN FLOOD ZORE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />J\\IlTDllR , COIlPAIIY ' /f,Sl'Jd C" Jl/Crvfc:-- <br />n~ State Cert. or egist.' / <br />Signature 1/ V City License Registration' IJ~..'2(/ <br />, ****************************************** ~ <br /> <br />F.l.F.CTRlCIAR COMPANY <br />State Cert. or Regist. . <br />SionAture City License Registration . <br />****************************************** <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />****************************************** <br /> <br />KECHANICAL COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />****************************************** <br /> <br />OTRF.R COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration # <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER, <br />