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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRBILIS <br />BUILDING DEPARTKENT <br /> <br />OWNER' S NAKE <br /> <br />tLJ.s;1I ~~/7 <br /> <br />~O~ /,~~- <br />, - <br /> <br />PHONE 78 .7 ~ DC> G <br /> <br />OWNER' S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />5S--I'~ <br /> <br />~// (Iu/. <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br />PARCEL LD.' /(- .;z t -.21. 0010 .. 00 S-7t!" ~ 0 .:LS-o (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction ~ddition ---..Alteration ~epair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />---3t/F <br /> <br />_' of Units _M/H <br /> <br />_~ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <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 /> <br />PERMITS REOUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />~CBAliICAL <br /> <br />$ <br /> <br />AIIP Service <br />if (CJ?J- JV <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />RT.F.CTRICAL <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUcnON: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FIRISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />RIITLDRR <br /> <br />Signature <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />:~~ COMPANY gc;/~,4.;l{) (./1:!//--A./"t',4:; ( /' : / <br />. {~ /? '~/O. State Cert. or Regist. . <br />e . %4'~ ~ .-/~4,-<W..(/ City License Registration . 07 e2. <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br /> <br />COMPANY /t\ c IV S ~/ <br />State Cert. or Regist. . 00 S-~ 1<- <br />City License Registration, I ~ :< <br />***************************************** <br /> <br />MECHANICAL <br /> <br />OTRF.R COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />