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<br />APPLICATION FOR PERKlT <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARTMENT <br /> <br />d ,/ 1'1 <br />I ~--I <br /> <br />JOB ADDRESS <br /> <br />C!JC{FleS <br />$'023 <br />,%23 <br /> <br />GrQ 5':;/ ~ <br />/ J;~ Sr/, <br />/]dtSl. <br /> <br />PHONE <br /> <br />, 7g 2 - 2 'IO?, <br /> <br />OWNER'S NAKE <br /> <br />OWNER'S ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.f ../j-- Z c; 2/-00/0- /O-,",oC'-~(OBTAIN FROM PROPERTY TAX NOTICE) <br />70 <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair ~Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_M/F <br /> <br />_' of Units _M/H <br /> <br />_ec:-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />____Restaurant lie Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS lie (2) SETS OF BUILDING PLANS lie (1) SET ENERGY FO . <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS lie (1) SET ENERGY FORMS. ~ g <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. ~ r: <br /> <br />PERMITS REOUESTED <br /> <br />____BUILDING <br /> <br />$ ~& f:S."- ~ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECIIAlflCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block ____Fr8lle _Steel <br /> <br />Other <br /> <br />FDfISBED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />Signature <br /> <br />CONTRACTOR SECTION <br /> <br />COKPANY f(J15 /)/UMr'r?VP1 f /YlQ 7tJ119/f t;~~ <br />~ ~. Sate Cert. or Regist.' C10 ,C'O 0/ 7 ~ <br />y" City License Registration' ':J't <br />**** *********************************** <br /> <br />RllTl.DER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration . <br />****************************************** <br /> <br />F.1.F.CTRICIAR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration f <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration , <br />****************************************** <br /> <br />MECBAHICAL <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. # <br />. City License Registration # <br />******.***.******************************* <br /> <br />nTRF.R <br /> <br />Signature <br /> <br />"7:'~:' <br />, i <br /> <br />,. <br /> <br />APPLICATION APPROVED BY <br /> <br />PERHlT OFFICER. <br />