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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARTMENT <br /> <br />/--9~ <br />,~:J- <br /> <br />OWNER'S NAKE <br /> <br />Viii II tlR-T/;J . <br /> <br />3 '13b a ClbNc~v <br />r-> / <br />>/f7'16, ~oT 7/ <br /> <br />PHONE <br /> <br />OWNER'S ADDRESS <br /> <br />!:-lJ <br />bt~}) <br /> <br />,Po ?/lIr .R.. V <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D.' <br /> <br />(OBTAIN FROH PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_Deaolish <br /> <br />P~POSED~E: _Si~leF~ily <br /> <br />_H/F <br /> <br />_' of Units ---.Ji/H <br /> <br />_<=<-ercial <br /> <br />_Indust. <br /> <br />_Swim. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />70 I ~5 77'Iz.,C- <br />r:'x/O, <br /> <br />k IbJcm,< <br /> <br />?if YtV h~'? ~ <br /> <br />BUILDING SIZE: <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 />_BUILDING <br /> <br />$ <br /> <br />//<g(P <br /> <br />PERMITS REOUESTED <br />. cJO <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 />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FllUSHED FLOOR ELEVATIONS: <br /> <br />F1' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA '1 <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />BUILDER <br /> <br /> <br />Y C/ A.J s 77ff€. <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />COMPANY <br /> <br />/K-lJ I-( /;Ut/~ <br />7U- <br /> <br />Signature <br /> <br />.::~. <br /> <br />...... <br /> <br />-,---'"':.~' <br /> <br />--~~"'-,.,-' <br /> <br />RT.RCTRICIAN COMPANY <br />State Cert. or Regist. . <br />Sianature 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 f <br />****************************************** <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration # <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />