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<br />APPLICATION FOR PERl-lIT <br />CITY OF ZEPIIYRIIILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />f) 17-r-1 ~ <br />73/0 :JH.'ifd/Y 1) r: <br />f'E I~' F: /YJ.R tj iLl-. 1- <br />. <br /> <br />fJ 1. f7 H/f j) fl <br />/(;,/ <br />;?3'- ~3 -- 4.1 -- <br /> <br />~t!L <br />.,? )RJ)25 <br />- <br /> <br />Co- <br />rL <br /> <br />PIIONE <br /> <br />7ffff--- J2jdt <br /> <br />ADDRESS <br /> <br />OWNER <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />LOT SIZE~X lOD AREA SQ,FT. <br />SUBDIVISION fi [P flFf Vl L 1-/1 t, t., <br />a LJ c/ d LJ /.6./ ~ ._____ <br /> <br />JOB LOCATION <br /> <br />3f?7/7/ <br /> <br />PARCEL I, D, ~~ <br /> <br />tJ a rg <br /> <br />WORK PROPOSED:A-New Construction _Addition _Alteration _Repair <br /> <br />Illstall <br /> <br />_Sign/Temp, <br /> <br />_Sign <br /> <br />_~Iove <br /> <br />_Demolish <br /> <br />PROPOSED USE: _Single Family <br /> <br />_M/F <br /> <br />_~~ of Uni ts <br /> <br />,._M/H <br /> <br />_Commercial <br /> <br />_Indust, <br /> <br />_Swim, Pool <br /> <br />5tf7/7 <br /> <br />Other <br /> <br />_Restaurant & Health Department Approval <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 & 0) SET ENERGY FORMS,** <br />COilllERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENEI,GY FORr-IS. ** <br />**COPY OF CONTRACT REQUIRED, <br /> <br />PERMITS REOUESTED <br /> <br />$-BUILDING <br />-A-ELECTRICAL <br /> <br />$ <br /> <br />C;000.170 <br /> <br />AMP Service <br /> <br />Valuation of Total Construction <br /> <br />)( Florida Power Corp. <br />. <br /> <br />_W,R,E,C. <br /> <br />_MECHANICAL <br />..x-PLUMBING <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block <br /> <br />_Frame _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT, <br /> <br />****************************************** <br /> <br /> <br />CONTRACTOR SECTION, 11" 0 {: <br />Company efJ.J ..5 0 0 tJ .1-- C7 . <br />State Cert, or [(cgist. !I f)P(J() rel? <br />C i t Y L ice n s e 1-: f'['. i~.; (, L\ t j () n it <br />****************************************** <br /> <br />Signature <br /> <br />ELECTRICIAN /~C~t'.J <br />';l <br />S i !!na ture It'-t" ./A"<-e.,-:..)' <br />, <br /> <br />G. cr-h-e_./ C~~ompnny CR !1I'1D fJ L- L- <br />eState Cert. or j{ep,ist:, II <br />~12-~ City License ]'('f~istt'ation II <br />****************************************** <br /> <br />~~ l-f-C;-,I1) L <br /> <br />~ 70<.. <br /> <br />PLUMRFR <br /> <br />~ Company I}- fl J '5 <br />/} -HI N 7- State Cert. or ]{('GisL. it <br />UA:tJl-bjA../l CY- L4Jr-c:6k'/ City License ]{e~:i.str"tion <br />~****************************************** <br /> <br />~~ 1- ~/X <br />Fj P dd .1/1' ~7' ? <br />IF 3d?.;;?." <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Company <br />State Cert, or Rer.ist, # <br />City License Rcp,istr"tion 0 <br />****************************************** <br /> <br />OTHER <br /> <br />Signature <br /> <br />Company <br />State Cert, or RCGist, it <br />City License Rer;istration it <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERl-lIT UFFICER, <br /> <br />"In <br /> <br />f <br /> <br />~~ <br /> <br />.- <br /> <br />1'< I' <br />, ~. <br />