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<br />APPLICATION FOR PERKlT <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARTMENT <br /> <br />'2. u.. c.) <br /> <br />- <br /> <br />OWNER'S NAKE \- \ I)(~ J ~ <br /> <br /> <br />OWNER'S ADDRESS ~\ ~C; <br /> <br />JOB ADDRESS 3R /3') <br /> <br />~ C~\f\\( <br /> <br />~lWW b9qN\'t' <br />~i\f~rl .~rc. <br />BLOCK <br /> <br />Jr,. <br />'3)n~!. <br /> <br />PHONE e)'?l )79 ~ . ,Sl \ <br />Z.\1'l\\~ <br /> <br />2t fV\y r l.," \ l.s. <br /> <br />~L. <br />\ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' (OBTAIN FROK PROPERTY TAX NOTICE) <br />Wd~ <br />WORK PROPOSED:_New Construction ____Addition ____Alteration ~Repair ____Install <br /> <br />____Sign <br /> <br />-1love <br /> <br />____Deaolish <br /> <br />PROPOSED USE: _S ingle Family <br /> <br />____"IF <br /> <br />____' of Units ____"/8 <br /> <br />_ec:-ercial <br /> <br />_Indust. <br /> <br />____Swia. Pool _Other <br /> <br />~Restaurant 1& Health Department Approval <br />DESCRIPTION OF WORK: F\At !<no{:. l).;U' (2Sf...21., ') <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 1& (2) SETS OF BUILDING PLANS 1& (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS 1& (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />~UILDING <br /> <br />$IJ100.0() <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_KECIIAIIlCAL <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUKBING <br /> <br />GAS <br /> <br />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 />BUILDER <br /> <br />COKPANY <br />State Cert. or Regist. , <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />ELECTRICIAN <br /> <br />COKPANY <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />SilmAture <br /> <br />PLUKBER <br /> <br />COKPARY <br />State Cert. or Regist. . <br />City License Registration , <br />**~*************************************** <br /> <br />Signature <br /> <br />KECHANICAL <br /> <br />COKPANY <br />State Cert. or Regist. # <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />OTHER COKPANY~ CJM!..trud10iJ I In( . <br />~y~ State Cert. or Regist.' Rl, 1~7.1\:" <br />Signature . .. y ~. City License Registration t <br />. ****************************************** <br /> <br />[,//. <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />