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<br />APPLICATION FOR PERKlT <br />CITY OF ZEPIIYlUII.LLS <br />BUILDING DEPARTMENT <br /> <br />"'" f.Pj~~l. ~5 <br />~ ., I~.t/l q It' ' <br />~~ .'P"- <br />. L to' <br />(f~ <br /> <br />('Jtld--/r.8'~T) <br />j/i:~ _ ~~ // <br /> <br />OWNER'S N~el/M.d AhlflJ{I fiE <br />OWNER'S ADDRESS ....g.!0 Z ,tff7:l'j L A /9./VF' <br />JOB ADDRESS S/'J/tIC <br />LEGAL DESCRIPTION: LOT(S) 11 R8 BLOCK <br />PARCEL LD.' ;;('i~;). ~ -~/--o-nv - tro Icro <br /> <br />PHONE <br /> <br />SUBDIVISION &~/Cj';.fcl flr~7E ~d~,fd <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction ~ddition --Alteration _Repair _Install <br /> <br />_Sign <br /> <br />--.JIove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_M/F _' of Units _M/H <br /> <br />_~ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />j//J,ef( IIZJj)n- <br /> <br />Se:T-l.( P <br />f <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKlTS REOUESTED <br /> <br />'><: BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />~ELEC'fRICAL <br />A,mCHAIIICAL <br />XPLUMBING <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUC'J'ION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />YES <br /> <br />~ <br />- <br />NO <br /> <br />FDlISHED FLOOR ELEVAnORS: <br /> <br />F'l' . <br /> <br />IS PROJECT IN FLOOD ZORE AREA? <br /> <br />.......................................... <br /> <br />PLUMBER. <br /> <br />CONTRACTOR SECTION <br /> <br />aJIIPA1IY L 07t1-u"-'-!"' <br />'" State Cert. or Regist. . <br />City License Registration' ~~D <br />........... .. ........................... <br /> <br />:::CIAH ~l ,~1 COMPANYflpe. r;1ef)-{ 'r1, <br />/}/ ' rr. \...."... State Cert. or Regist. .~~/ <br /><!:. 'Ji/ -fA; ('1. vV VL City License Registration t , ~ <l- <br />· ...................................... I 7J ' { <br /> <br />COMPANY ..x:t~L 4".A.!-v-' <br />State Cert. or Regist. . Q <br />City License Registration f 07~~o <br />.***..*..*.....*......~ ~C!~ <br /> <br />COMPANY <br />State Cert. or Regist. <br />City License Registration . <br />*..*....*...**.......*..*.*..*.*.....* <br /> <br />BUILDER. <br /> <br /> <br />Signature <br /> <br />Signature <br /> <br /> <br />Signature >( <br /> <br /> <br />KECBANICAL <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />....*...*.........*....................... <br /> <br />APPLICATION APPROVED BY PERKlT OFFICER. <br />