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<br />APPLICATION ~OR PERKIT <br />CITY OF ZEPIIYRlIlLLS <br />BUILDING DEPARTMENT <br /> <br />6J.uo;i ~- 'i~7l <br />C!~) <br /> <br />OWNER'S NAHK LEoN M~~R- <br />OWNER'S ADDRESS (p \ '3 q A ~ (\. T ~ <br />JOB ADDRESS (p l 3 ~ A (,.A, ~ <br /> <br />PHONE ? t;J.-~ t / 6 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION D4- k s/ D c- ~ {if -,a <br /> <br />PARCEL 1.0.' (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED: ~ Construction ----Addition ----Alteration ____Repair ____Install <br /> <br />_Sign <br /> <br />--..Hove <br /> <br />~e.olish <br /> <br />. <br />PROPOSED USE~ _Single FUllly <br /> <br />~/F <br /> <br />____, of Units ____Mill <br /> <br />_C...ercial <br /> <br />____Indus t. <br /> <br />____SwiM. Pool ___Other <br /> <br />_Restaurant & Health Departaent Approval <br />DESCRIPTION OF WOItK:~ I2PdVL f S /-Iu D l;/- ~ elL/!,; r <br />BUILDING SIZE: 7 x / ~ ~~ Square Feet, ~ Height <br /> <br />RESIDENTIAL: <br />COHHERClAL : <br /> <br />ATTAL1I (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTAL1I (3) SBTS Of' BUILDING l'LANS & (1) SET ENERGY FORMS. <br />PROPIUlTY SURVBY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />____BUILDING <br /> <br />oJ <br />$ 1~-JL9o~ <br /> <br />PERMITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />_ELEC'fRICAL <br /> <br />AH.P Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />--1IECIIARlCA.L <br /> <br />$- <br /> <br />Valuation of Hechanical Installation <br /> <br />_PLtJHBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRuctION: _Block _Fr_e _Steel <br /> <br />Other <br /> <br />FUISUED FI.OOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS 'PROJEC'f IN FLOOD ZONE AREA? <br /> <br />BUILDER <br /> <br /> <br />YES NO <br /> <br />............::::::.:::::............ 19;~: {q ,,, <br /> <br /> <br />COKPANY A c f A 1\AvV\I' V'l u............ <br />State "erL 0::- Regist. f Q r2 co 'J>c t. r-<J <br />City License Registration t /~ ~ <br />.......................................... <br /> <br />Signature <br /> <br />EI.EctRlCIAR <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration f <br />.......................................... <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration f <br />.......................................... <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />HEGlIANICAL <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />