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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPIlYRlIlLLS <br />BUILDING DEPARTMENT <br /> <br />I' <br />o f f(?~~r" 09- <br />1_i)/-VV. <br /> <br />OWNER'S NAME <br /> <br />DDn,wld <br /> <br />(-tj D~(lJ ) ked'1 <br /> <br />PIlONE '1i)"J - 29 2- - 0"7 oS' <br /> <br />OWNER'S <br /> <br />AUDRESS e f () 2- L/~~~ ~ <br /><:539 0c26~f.j1""""A1 <br /> <br />Or) -.k, F'/...., ~ z. 9 Zr 1-- <br /> <br />, <br /> <br />~"~- Z-c:V')..,rl..if~ J r~ <br /> <br />SUBDIVIS~ON :; ;tttM-e'Y )/,1/ <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) ~ BLOCK <br />PARCEL 1.D.# J2--U- Z/-O/OD'()OOeJO-'" 0070 <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOsED:~New Construction _Addition -^lteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Demolish <br /> <br />PROPOSED USE: ~Single Family <br /> <br />-"'F <br /> <br />_' of Units _MIll <br /> <br />_Commercial <br /> <br />_lndust.. <br /> <br />_Swim. Pool ___Other <br /> <br />BUILDING SIZE: <br /> <br />Restaurant. & Ilealt.h Department Approval <br /> <br />C{j~j;~ IJ,.~ t~JJvvv.ir~'v <br />I. B; J?/~'L- <br />~L> xll'f6, 3tJ~1 Square Feet, Ileight <br /> <br />DESCRIPTION OF WORK: <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PWT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTA~ll (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />~BUILDING <br />&LE<.7RICAL <br />X MECHANICAL <br />~LUHBING <br /> <br />90} h;;, -- <br /> <br />$ <br />;too <br /> <br />ljooo - <br /> <br />AMP Service <br /> <br />Valuat.ion of Tot.al Const.ruct.ion <br /> <br />~ Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br />..KBlock <br /> <br />X ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: <br /> <br />_Fralle <br /> <br />_Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? K <br />YES NO <br /> <br />..........................***..****.***... <br /> <br />BUIIJ)ER <br /> <br /> <br />CONTRACTOR SECTION <br />15/1 j fL- &-lr~J..~; ~ <br />S t.at.e Cert.. or Regis t. f e,.,I2-L ()<;; {, I i I <br />City License Registration I ZVe. <br />.*...****..***.***********..*...*********. <br /> <br />COMPANY <br /> <br />/ <br /> <br />Signature <br /> <br />:::CIAN j} 1). ~~=:::.~erL ~i~I'-'''~7'l.f / It>> ~.;ni.. ,/ <br /> <br />__ _-yce ~ City License Regist.rat.ion t a'!f}J.. 9' <br />. .......................................... - - V;~~. <br /> <br />PLUMBER ~ COMPANY l::;CJ~' <br />/J " A State Cert. or Regist. t V <br />Signature I'...t, ,/. .JU-- city License Registration #I . <br />. .***'*****.******************************* <br /> <br /> <br />Signature <br /> <br /> <br />. COMPANY L S'6"'''i · s f) s,;.:;...J- ~~ <br />~ ~ State Cert. or R -gist. . ~ '."--1 "^ .~) & 'ri-I <br />City License Registration f ~~~ <br />*.. **.************...*******.*****.**** <br /> <br />/ <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />OTIIF.R <br /> <br />COMPANY If - / ~A /:J:- <br />State Cert. or Regist. #I /l. e. ~Z<r' <br />City License Registratioat I <br />***......*****.***.*..*.**..***.*********. . ~ I{~ <br /> <br />~ <br />~ <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />