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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPIIYRlIILLS <br />BUILDING DEPARTMENT <br /> <br />~ v<> ;-41 <br />~qO',/;) <br />~/iI-"';"" F~11 PHONE 113 - 'S-(l~' 'II/'ll) <br /> <br />, <br /> <br />~ 8r~~...... ~~J~ :?5S1/ <br /> <br />, <br /> <br />/'k.i..., / J:/V'- {)#tj, ~'-"/I;"Iih ~I ~. .:?lJ)7 <br />BLOcwf4S"tLsuBDIVISION ~/~ ~lJ <br />l>o;,;,ve.! - /2&;OCOBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />OWNER'S NAME <br /> <br />/h l(;i~1 (~ <br />:$/ l) 'b i1t/dt t//~'- <br />6/ / / .!</V~ "~5 <br />Lof /1-~ <br />f) 3- 2b - 2/ - ()Izt>- <br /> <br />OWNER'S ADI)RESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />PARCEL 1. D. # <br />WORK PROPOSED:~New Construction <br /> <br />-^ddition <br /> <br />_Alteration <br /> <br />____Repair ____Install <br /> <br />_Sign <br /> <br />_Kove <br /> <br />_Demolish <br /> <br />PROPOSED USE: ~ing1e Family <br /> <br />_M/F _# of Units _Mill <br /> <br />_Commercial <br /> <br />_Indust. _Swim. Pool _Other <br /> <br />____Restaurant & Health Department Approval <br /> <br />DESCRIPTION OF WORK: 5h'~ /J;-./7 CJj,~ ~~ <br />1/' 'Ii' I ),~., '7'7!f,;; []' 10' I'*'fj... I/,. fl.-pv. f' ~f'I-l <br />BUILDING SIZE: ) X ~;:1 I, >:>1 Square Feet, HeigHt c,' "~) <br />z- Uf <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTAL11 (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~UILDING <br />ALE<."-RICAL <br />LHECHANICAL <br />LPLUHBING <br /> <br />PERMITS REOUESTED <br /> <br />Valuation of Mechanical Installation <br />X ROOFING <br />Y Ii v ~~ <br />TYPE OF CONSTRUCTION: ~ ock ~Fr88le _Steel <br />FINISHED FLOOR ELEVATIONS: ~11<<'(FT. IS PROJECT. IN FLOOD ZONE AREA? <br /> <br />$ J } 5"'; IJC>D .- <br />. , <br /> <br />200 <br />Jft,oo- <br /> <br />AMP Service <br /> <br />Valuation of Total Construction <br /> <br />~ Florida Power Corp. <br /> <br />W,R.E.C. <br /> <br />$ <br /> <br />GAS <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />YES <br /> <br />* <br /> <br />..................................******** <br /> <br />BUILDER ~ ro~~=:N:ES;J ~ t2I-I-~ <br /> <br />State Cert. or Regist. , c.. as 'b/q / <br />Signature City License Registration # 2$16 <br />~ . ...**.**.***.****************.**.********* <br /> <br />/' <br /> <br />ELECTRICIAN COMPANY e~ /JcU;"Jl., <br />::::: ~ 0 ~ _~ State Cert. or Regist. , <br />u ~ ..L/'\ ?tt,Y7'T) City License Registration f <br />****************************************** <br /> <br />DOu:z... 7?S <br /> <br /> <br />PLUMBER COMPANY ~j4 <br />State Cert. or Regist. , i <br />Signature City License Registration t <br />****************************************** <br /> <br />MECHANICAL ~ . COMPANY 5" O##V 5- JkDo/~) J)1ff/.44..- <br /></ ~ ~ State Cert. or Regist: f IZJntJOCJ~/ /ljr...tfJo/st'b1 <br />Signature~ ~ City License Registration' ~ <br />*** *** ********.****.****..*********** <br /> <br /> <br /> <br />1/' <br /> <br />/. <br /> <br />OTHER ~ COMPANY <br />State Cert. <br />Signature ,~ City License Registration , <br />~ ..*****************************.********** <br /> <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />