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<br />APPLICATION FOR PERHlT <br />CITY OF ZEPIlYlUIILLS <br />BUILDING DEPARl'HENT <br /> <br />~wI~" !~~-?~/!~7'7 <br />1r ~",'~ lkr rrD <br />~J~ fd ~^-r7 <br />t -Jl-I <br />PHONE 91/- ? 3t.{ <br /> <br />OWNER'S HAKE AAtJ t//l/Aje '&J~ <br />/ <br />OWER'S ADDRKSSn~S/ !tf!;!':a;~ ' <br />JOB ADDRESS t9'1_ __ __ <br />I f!tJ4~-e 0 4 , J/,.- <br />LEGAL DESCRlPTION: LOT(S) L/9 BLOCK a. SUBDIVISION ~ 6/J~ <br /> <br />,t', '" <br /> <br />PARCEL :LD.#' :5-~~OJI- 0166 - COt:::Ja:) -0'/70 (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:.K.wew Construction ---..Addition ---..Alteration ---..Repair . Tn_tall <br /> _Sign ---.JIove ---Peaolish <br />PROPOSED USE: .)( Siogle Fully ---.JI/ F _' of . ,Units ---If./B <br /> _ec:-ercia1 _Indust. _Swia. Pool ._Other <br /> <br />---..Restaurant & Health Departaent Approval <br /> <br />DESC1lIPTl:OR OP WOBK:~ -H &. <br /> <br />BUILDING SIZE: X , ~;::L- Square Feet, Height <br /> <br />RESIDEHTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET BBBRGr FOlUtS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOlUtS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />RI.F..CrIUCAL <br /> <br />PERMITS REQUESTED <br />$ 'JO.CJOO Valuation of Total Construction <br />, , <br /> <br />/ ~ 0 AKP Service X Florida Power Corp. <br /> <br />:-. I" <br /> <br />~UILDlHG <br /> <br />. 'd <br /> <br />W.R.E.C. <br /> <br />----1fEClL\BICAL $ <br /> <br />'3100 <br /> <br />---PLUKBING <br /> <br />GAS <br /> <br />Va1uation of Mechanical Installation <br />~PUJG SPECIALTY <br />_Fr_e _Steel Other <br /> <br />TYPE OF CORsnucn.ON: <br /> <br />~lock <br /> <br />FIRISBBD' FLOOR ELEVAnORS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES . NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION' <br /> <br />1lJU1.QBR OOIIPAIIY ~. Zj~ ~ <br />A ~ 9' State Cert or Rea . # 91?1 <br />Signature ~ ~ City License Registration' 1'0 <br />~ .............*.*****.............**...*... <br /> <br />RI.RCTRICIAB ' ,COMPANY .51-.5 ~ .' " <br />~ /l /7 '2 __ State Cert. or Reaist. . <br />SiDnAturey 4/n.A" 0 . ~0~ . City License Registration'. 3(J() <br />...............*................*......... <br /> <br />PLUMBER <br /> <br />COMPANY IIA~M-b~ I ~ <br />Vtf) ~ ' State Cert. or lIe&ist. , <br />City License Registration' 1.37 <br />.....' ................................... <br /> <br />Signature <br /> <br />tIE~ICAL' , J /) <br />Signature ~~~~ <br /> <br />COMPANY <br />State Cert. or Regist. . Co CD 3~ l/"-/) <br />City License Registration' d-.g3 <br />.......................................... <br /> <br />fJ.. rz c --IJ (c.. <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br /> <br />(,."" .~~ 'n~......... <br />~..... ;xJIIt lllIQC) <br /> <br />w <br /> <br />t <br /> <br />"lJPFICER. { <br />I <br /> <br />I <br />" t <br /> <br />'~'i <br /> <br />".",-...~ -~--_....._-....... ... <br /> <br />. . <br />......_._..v_..-"',....__' <br />