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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARTMENT <br /> <br />~0/P~~ <br /> <br />OWNER · S NAHE <br /> <br />3-1\ v-'\,~.\. .; 0c/lfl< (?..h"~6B <br />~ /0 7 ,Uo~" ~L'C K <br /> <br />PHONE <br /> <br />OWNER' S ADDRESS <br /> <br />~ )D) 1~~l)(K~ ~/C <br />LEGAL DESCRIPTION: LOT(S) q BLOCK SUBDIVISION sr ~h c:./^...J:S ~ A.J AI <br />SI / t.J ell CJ1 J::s <br />PARCEL 1.0.' D S. Gk. .2/- 01 )U. 0Cfl:.X) 'CC>; 0 (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />JOB ADDRESS <br /> <br />WORK PROPOSED:_New Construction ~tion --.Alteration _Repair _Install <br /> _Sign --.Hove _Deaolish <br />PROPOSED USE: _Single Faaily --.H/F _' of Units --.H/H <br /> _eo..ercial _Indust. ~im. Pool _Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />S~\~~\",-\ ~~ S b~, t <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL <br /> <br />ATTACH (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 />~ e.9. <br />J-1, ;JOO <br />~. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />Valuation of Total Construction <br /> <br />_ELEC'fRI.CAL <br />_MEClWiIGAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fralle _Steel <br /> <br />Other <br /> <br />FIRISBED FLOOR ELEVAnONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />BUlI.J)ER <br /> <br /> <br />YES NO <br />.......................................... <br />, tP(j,UW <br />CONTRACTOR SECTION ~ ~ 01 '" . J <br /> <br />COMPANY U, II D Pc:u{ S 7' ...:>c. CflVL 1<-,5, P ~ff ~ <br /> <br />State Cert. or Regist.' C PC.JOI ~R ~ <br />City License Registration' 1/ <br />.......................................... <br /> <br />Signature <br /> <br />omRR <br />Signature 0: <br /> <br /> <br />COMPANY.J:tA t.U/(., 11 S cl e.c:trl CA.. ~ Sf V . <br />State Cert. or Regist. , E~~~""Z-~L <br />City License Registration . /alL- <br /> <br />.........::...f,~:.P:;,i;( ~ elL" P. ~7Y ) <br /> <br />State Cert. or Regist. , <br />City License Registration' II J <br />..............................tt ~........... '. ,- <br /> <br />COMPANf=.-- k0. ro fr,,-..-j,,-- ((~~ 4 .i~5 /~ ~c7?iC ) <br /> <br />~ <br />State Cert. or Regist. , <br />City License Registration , <br />...........~.............................. <br /> <br />COMP -::>>7~. r:J:i7rlC;Y ~,,),;.lA/C./""<JA~. <br />ate Cert. or Regist. . <br />City License Registration , <br />........................... <br /> <br />ELECTRICIAB <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />