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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIY1UIILLS <br />BUILDING DEPARTMENT <br /> <br />,E {, fl: (. r/tl C S /' (,u''7' ('= c), <br />8-fJ - {, s-tt,-?.l yD <br />r- } .5--7?' <br />7Rz- Y.J?O <br />PHONE '12 J - 7~ 37 <br /> <br />OWNER I S NAME <br /> <br />fJA-v /P p" r!/-';~J <br /> <br />OWNER'S ADDRESS S-S~&1 S/ Y 7d J h <br /> <br />JOB ADDRESS <br /> <br />0- S'()O .vyTft' sT: <br /> <br />LEGAL DESCRIPTION: LOT(S) LAJr.r/'" F/flfJlt"l BLOCK "f61 SUBDIVISION <br />;K 1lfltt.f:;:; L~: ;:;;; 2.,4 jJ L Clef';: 941 (OBTAIN FROH PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration ~epair _Install <br />~Sign _Hove _Deaolish <br /> <br />PROPOSED USE: _Single Faaily _H/F _' of Units _H/H <br /> <br />,2(.eo..ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />j>'F t T~~ " <br /> <br />J Lc//f(,.{,. J IllY f <br /> <br />BUILDING SIZE: yo X it; , /'-/ f 1 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 />_BUILDING <br /> <br />$ ~ rO 2> <br />/ <br /> <br />PERMITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />_ELEC'fRICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHAIIICAL <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />_PLUHBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FDlISBED FLOOR ELEVATIONS: <br /> <br />PT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />/ <br /> <br />Signature <br /> <br />i ~. ClIIIPARY /ft-;rci ,,-/v 5'/6"-' C (). <br />, State Cert. or Regist.' E5 00 tJ l-l.. <br />il~ ~ City License Registration' ~ / ':? <br />~-- ....... .................................. sr . <br /> <br />RIITIJ}ER <br /> <br />F.1.F.C'fRICIAR COMPANY <br />State Cert. or Regist. . <br />SiooAture 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 />OTRF.R COMPANY <br />State Cert. or Regist. f <br />Signature City License Registration I <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />