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<br />APPLICATION FOR PEmfiT <br />CITY OF ZEPRYRRILLS <br />BUILDING DEPARTMENT <br /> <br />~ 11l!26CO- <br />DATE RECEIVED f <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME Of/AN/) <br />JOB ADDRESS 3'7 S 3'1 <br /> <br />It~ ILl 2Drl <br />Lo ILJ1tv It <br /> <br />m.H. f. <br />flv I~ L-I.> r <br /> <br />PHONE 7f z- 10"9 <br /> <br />III <br /> <br />SUBDIVISION (;1/Afc.I:J /-IaN Z(Yt.I I'1H ,.f, <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID # 3t{-U""-Z-I- 0010 - 0/ 36)0 - 0 Ii l <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: ~W CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />I!3"1NSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING OMULTI-FAMILY 0# OF UNITS 0 MOBILE HOME <br />o COMMERCIAL 0 INDUSTRIAL 0 SWIMMING POOL ~HER <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL jU..... Vm I /yvm PAd'-..A6(:. <br />DESCRIPTION OF WORK PA-tseo ~/I.I 12Ifht(/ CAilPbl-f( (/-f2.tJOitlt <br />7{J <br /> <br />BUILDING SIZE /U1. ,llK/l. 2-D 'f vi <br />, , <br /> <br />SQUARE FOOTAGE <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 />~UILDING <br />~LECTRICAL <br /> <br />PERMITS REQUESTED <br /> <br />$ <br /> <br />ILtDDD . 00 <br />, <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o <br /> <br />W. R. E. C. 1.-11 (lE stIf:p <br /> <br />o PLUMBING <br /> <br />o ME CHAN I CAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br /> <br />SIGNATURE <br /> <br />i3vw II. ahl <br /> <br />COMPANY-.fuJ! c ~~nlJ~ 0(= C6t.i1~ R..-. <br />STATE CERT OR REGIST # CBc.{)srJf)t!"z <br />CITY PROCESSING # 2lP <br /> <br />BUILDER <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />r~AA~ A-. aM2 <br /> <br />COMPANy---B-q- fil,fcTIUc <br />STATE CERT OR REGIST # <br />CITY PROCESSING # 1~'7 <br /> <br />ELECTRICIAN <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />* * * * * * * * * * *,* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * <br /> <br />MECHANICAL <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />