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<br />APPLrCATrON FOR PElUaT <br />CITY OF ZEPBYRRILLS <br />BUrLDrNG DEPARTMENT <br /> <br />DAD RECErvBD <br />PLANS REVrBlf :&'BIll <br /> <br />OWNER'S NAME (;-'A/4,v) )fO{l,/~c;-'\1 If<..." _-' <br />JOB ADDRESS L" r 7.> <br /> <br />PHONE <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br />WORK PROPSED: ONEW CONSTRUCTION <br />o SIGN <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMME~CIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />frMOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />ht..f{ <br /> <br />BUILDING SIZE <br /> <br />Lo'f5~ <br /> <br />SQUARE FOOTAGE / 5- G "z( <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 />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <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 />BurLDER <br />SIGNATURE W ~~M <br /> <br />****************************************************************** <br /> <br />COMPANY <br />STATE CERT OR REGIST # ) <br />CITY PROCESSING # ~~ <br /> <br />EL1!:CTlUCIAN <br /> <br />SIGNATURE <br /> <br />PLUMBll:R <br /> <br />SIGNATURE <br /> <br />~' ''-'y--fi~1 <br /> <br />COMPANY <br />STATE CERT OR REGIST <br />CITY PROCESSING # <br /> <br />MBCIIAlUCAL <br /> <br />* * * * * * * ** * *.* * * * * * * *** * * * * * * * * * * ** ** * * *.* * ** ** * * * * ~* **J17! ** * * * * * <br />COMPANY. A- C , _ <br /> <br />SIGNATURE <br /> <br />~ <br />v.-J (~/0.'- dh <.-) <br /> <br />***************************************************************** <br /> <br />STATE CERT OR REGIST # <br />CITY PROCESSING # '71~ <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />