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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPAR'l'HENT <br /> <br />OWNER' S NAHK <br /> <br />.f: t' A/J/( j) <br />6.3'0/0 <br />~/Pe- <br /> <br />:!JAkl74- /I <br />.3 ~// .f..Qe>C' 7'- <br /> <br />PHONE <br /> <br />OWNER' S ADDRESS <br /> <br />7 0 /L <br />.::-.--,.." r.?... <br /> <br />,-? ~~-~.:..; <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCIL--.SUBDIVISION <br /> <br />PARCEL LD.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction ---..Addition ~teration ---Repair _Insta11 <br /> <br />_Sign <br /> <br />---.JIove <br /> <br />--.J)eIIo1ish <br /> <br />PROPOSED USE: ~iog1e F8Ilily <br /> <br />---lt/F _' of Units ---lt/B <br /> <br />_ec-ercia1 <br /> <br />_Indust. _Swill. Pool _Other <br /> <br />---.Jlestaurant &: Health Depart:llent Approval <br />DESCRIPTION OF WORK: /;V~ ~LL ,f/C ~ &4/ <br /> <br />11/ /EkC~G ~~"f'4Pe., <br /> <br />" <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDEIITIAL: AtTACH (2) PLOT PLARS &: (2) SETS OF BUILDING PLANS &: (1) SET ~ERGY FORMS. <br />COMKERCIAL: AtTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REOUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />'ff7V <br />295'3- <br /> <br />Va1uation of Tota1 Construction <br /> <br />RT .R.C'l'RI.CAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-.JIECIIAI[(CAL <br /> <br />$ <br /> <br />Va1uation of lIechanical Installation <br /> <br />-PLUllBIRG GAS ROOFING <br /> <br />SPECIALTY . <br /> <br />TYPE OF CONSTKUCTION: _____lock -"r8lle _Steel <br /> <br />Other <br /> <br />FDfISJIED .FJ.OOll ELEVAfiONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZORE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />,. <br /> <br />WllPARY <br />State Cert. or Regist. . <br />City License Registration # <br />.......................................... <br /> <br />BIITTJlER <br /> <br />Signature <br /> <br />RT.R.CTRICIAR COKPARY 7-:=. \""\'-'-, \2:.. ~'-"' - $'~ \ <br />~~' ~ State Cert. or Regist.' oou:)...... l ~ <tr <br />Signature ~. ~ e . City License Registration. # q (p <br />, .......................................... <br /> <br />PLUllBER COtIPARY <br />State Cert. or Regist. . <br />Signature City License Registration # <br />.......................................... <br /> <br />IlI!aIAIIICAL /:7 ,...;:;:____ V COIlPAIIY ;2Q~ T &.-z/AE ~ -I A..- <br />Sigoa-.o L~/~~ ~~eL~o~.:~~~~: Plf/,~/J <br /> <br />... ..................................... <br /> <br />OTIIRR COIIPARY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />APPLlCAfiON APPROVED BY PERHlT OFFICER. <br />