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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPllYRllILLS <br />BUILDING DEPARTMENT <br /> <br />/'t" <br />/ I It; <br />10 <br /> <br />OWNER' S N~ \ ~ +- ~~\A-- Q..~ \1 PHONa.(g t~ I IS- - ,~q I <br />OWNER'S ADDRESS bl'1'" S /fAn" e...e;. r (*t'JE \ ~PH"""i?-l+i US ) TL .S3.s-4I_ <br />JOB ADDRESS S-( ~ C) SH- M::."1 fLe-..r u-N E ? ~ eJ.f.( LLS I FL. $ ,<s-4- J <br />LEGAL DESCRIPTION: LOTJ.8L (0 I BLOCK SUBDIVISION <br />PARCEL loD.' lo - '2 b - 2.1 - 00 \0- oqqoo - O(t)C:> (OBTAIN FROM PROPERTY TAX. NOTICE) <br />WORK PROPOSED :_New Construction ~Addition ---.ft].teration ~epair _Install <br /> <br /> _Sign _Kove _Deaolish <br />PROPOSED USE: /Single Faaily _KIF -' of Units _K/B <br /> _ec-ercial _Indust. _Swia. Pool _Other {. <br /> " <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: Sc..~~N R.oo'M ,<;HE'J::> + ~Poe\ <br />- ( <br />BUILDING SIZE: I !;. X 2...~, 42-0 Square' Feet, <br />to I )< 2..0 ( 40 0 <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />COmtERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~PIT(ON To l(-o"&l~ <br />ltoM e: <br /> <br />Height <br /> <br />PERKITS REOUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br />, <br /> <br />_ELEC'J'RICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />----1IECHAIlICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ' ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED 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 />RunnER o~. N~ COMPANY CJ l,() Ne1e.... <br />State Cert. or Regist. . <br />Signature ~ ; Q., t:'~ City License Registration . <br />, ****************************************** <br /> <br />~.RCTRICIAN COMPANY <br />State Cert. or Regist. . <br />Si~Ature City License Registration . <br />****************************************** <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />****************************************** <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration . <br />****************************************** <br /> <br />OTIJRR COMPANY <br />State Cert. or Regist. f <br />Signature City License Registration , <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />