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<br />APPLICATION FOR PERHIT <br />CITY OF ZEPIIYRBILLS <br />BUILDING DEPARl'HENT <br /> <br />cyr,# <br /> <br />J0 <br /> <br />OWNER'S HAHE .,6-> ~ y 7// / /Ry '-<.. <br />OWNER'S ADDKBSS /'7 ~S/ .<9~t:.t ce $t9 ;t!)~i.J)tI'.s <br />JOB 'ADDRESS LAe" ReL N~D'" ,()RI ~ <br />LEGAL DESCRIP'lION: LOT(S) ~-g BLOCK SUBDIVISION ."5/Lt/eR - O~& <br />PARCEL I.D.' Os - 01' ~I -OI;}O. MOd 0 dloo8 (OBTAIN FROM PROPERTY ~~' NOTICE) <br />WORK PROPOSED: ){New' Construction ---.Addition ---.Alteration -Jepair TnAtall <br /> <br />44/L~eR <br /> <br />PHONE <br /> <br />9''j/-?J hL <br /> <br />,>, <br />/..-9~p~ <br /> <br />;::;t!...,I1 <br /> <br />_Sign. <br /> <br />. PROPOSED USE: Y Single F8ally <br /> <br />-----1Iove --.->>eaolish <br /> <br />-----1I/F _, of ,Units ----lt/B <br /> <br />_eo..ercial <br /> <br />_Indust. _swia. Pool ,_Other <br /> <br />-Jestaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: /)1A,/JLex <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDEHTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOlUfS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORIIS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />----1IECllABICAL <br /> <br />$ 7'~ ~O <br />/5::> <br />$ e2 X>o Valuation of flechanical Installation <br />GAS ~FDJG SPECIALTY <br />TYPE OF COBSTRUcnON: Y Block _Fraae _Steel Other <br /> <br />i! <br /> <br />----..BUILDING <br /> <br />Valuation of Total CoDS,truction <br /> <br />'.1::,' <br /> <br />RI.F..CTRI.CAL <br /> <br />AHP Service <br /> <br />--x <br /> <br />Fl.orida Power Corp. <br /> <br />W.R.B.C. <br /> <br />---..PLUflBIBG <br /> <br />FDlISBED' FLOOR ELEVAnOBS: <br /> <br />Fl. <br /> <br />,IS PROJECl :IN FLOOD ZONE AREA? <br /> <br />YES 'NO <br /> <br />.......................................... <br /> <br />BITTI.DER <br /> <br /> <br />CONTRACTOR SECTION' <br /> <br />*~~ <br />IXIIIPAIII' :J: ... · M <br />State Cert. or Regis . . ',' ," , <br />City Lic e Registration , ~J ) 9~~~ <br />.......................................... <br /> <br />~' <br /> <br />Signature <br /> <br />RI.RCTRICIAB COMPANY' S-rS' ~ ' <br /> <br />;p. , ~ /? ~ State Cert. or Regist. . <br />S:hmAture ~~ I A' ' City License Registration.' ~ <br />.* ....................................... <br /> <br />~' <br /> <br />Signature <br /> <br />4 1XIIIP.m' ~ -- + ~. <br />w f) / " State, Cert. or Regist. . <br />\. , City License Registration I /'?7 <br />~ ................................... <br /> <br />v <br /> <br />PLUflBER <br /> <br />IlECllABICAL /1 /) Q ("') <br />Signature cp/-('~~ ~ <br /> <br />COMPANY .p e" C j::::J r ~ C? C> <br /> <br />State Cert. or Regist. , CA co 5-+ l( t.../.? <br />City License Registration' ~S~ <br />.......................................... <br /> <br />~/ <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. I <br />Signature City License Registration , <br />.......................................... <br /> <br />APPLlCAnON APPROVED BY PERHIT OFFICER. <br />