Laserfiche WebLink
<br />APPLICAnON FOR PERKIT <br />CITY OF ZEPIIYRIIILLS <br />BUILDING DEPAR'l"HENT <br /> <br />9/6/ 0 (J R.~ c Q ~ \j ~ 01 <br /> <br />OWNER'S IWIE <:PrA:Ti<' l(' t-tr\- 5-Y) l n-.t PHONE 81.=so '1 \("~. 6 3>I.oD <br />OWNER'S ADDRESS S'til YOfL'~_5 Nt \L?-. DI2.) Z E~\l e.ilill S J r=-I., ..3.3SY-L <br />JOB ADDRESS S flt-i I Y OQ./L SN I Q ~ '1) fL Z.E PI'H{ (Z}.t"t Us I F I, 335Y I <br />LEGAL DESClUPlION: LOT(S) 83 B~SUBDIVISION w~t:.. c....DCOD. <br />PARCEL LD.' 10 21o ~, Df 7-0 00000 OlS-:,O (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:__ew Construction ~ition --."A1teration ~epair _Install <br /> <br />_Sign <br /> <br />-"<>>ve <br /> <br />->>eaGlish <br /> <br />PROPOSED USE: ~ingl.e F_ily <br /> <br />--..Jt/F _' of Units --..Jt/H <br /> <br />_ec-ercial <br /> <br />_Indust, _Swia, Pool _Other <br /> <br />~estaurant & Health Departaent Approval <br />DESCRIPTIOII OF WORK: .pu)D tTlD"-\ It:> ~-r-\ (L (')~ ria M.F-_ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDEIITIAL: ArrACK (2) PLOT PLAIIS & (2) SETS OF BUILDING PLANS & (1) SET EllERGY FORMS, <br />COMMERCIAL: ArrACB (3) SETS OF BUILDIIIG PLANS & (1) SET EllERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW COIISTRUCTION, <br /> <br />PERKITS REOUESTED <br /> <br />-BUILDING <br /> <br />$ t~\ t~ <br /> <br />Valuation of Total Construction <br /> <br />RI-RCTlUCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C, <br /> <br />--llEClWJICAL <br /> <br />$ <br /> <br />Valuation of Ilechanica1 Installation <br /> <br />~UMBIRG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE 9F COIISTRUCTIOII: _Bloclt -"raae _Steel <br /> <br />Other <br /> <br />FDlISBED FLOOlt ELEVAnOIlS: <br /> <br />FT. <br /> <br />IS PROJEct IN FLOOD ZONE AREA? <br /> <br />RIIlJ.DRR <br /> <br />YES NO <br />.......................................... ,/ <br />/; , o~.,) <br />COIITRACTOR SECTION S 2 - <br />IDIPAIIY CLljJ ll,i-i ~ +J~ CQ.\l Snl.lJ.CTlo~\ <br />State Cert. or Reg st. . <br />City License Registration I ..,.., <br />...................................... <br /> <br /> <br />~ <br />..;r- <br />WL- <br /> <br />RI.RC'l'RICIAII . 'COKPAIIY 5rt:w {\-lLl ~~TTLl C . <br />Sl"':"':,-Z\~~.Q;\---_______f / ~~teL=:"'O~~~:~~;;~~J<\ ~ <br /> <br />~=r;'-' .......................................... ...;C:> '-c.. >t oJ< ~ <br /> <br />PLUMBER COKPAIIY <br />State Cert. or Regist, I <br />Signature City License Registration . <br />.......................................... <br /> <br />~CAL~ <br />Signature ..., <br />/ <br /> <br />~~ COHPAllYU,N;;E~/).J/ (;{;/IJr0d.f <br />State Cert. or Regist. I /{tJ1t)O!602.-L <br />City License Registration I ~ 3 <br />, <br />.......................................... VJC <br /> <br />OTRRR <br /> <br />COKPAIIY <br />State Cert, or Regist, . <br />City License Registration , <br />.......................................... <br /> <br />Signature <br /> <br />APPLICAnON APPROVED BY <br /> <br />PERKIT OFFICER, <br />