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<br />APPLICATION FOR PEmfIT
<br />CITY 01' ZEPRYRRILLS
<br />, BUILDIHG DJ!:PARTMJmT
<br />
<br />DATi: lU!:CBIVJ!:D ,1/ --/--D /
<br />PLAHS REVtn 1'&2-
<br />
<br />fJj~cjf:;;tk~.,IAC .
<br />
<br />})-
<br />03 -:J~ ~;) /- o;;oo~ OOtOO -tJ'J- df)
<br />WORK PROPSED: ~NEW CONSTRUCTION
<br />dSIGN 0 MOVE
<br />PROPOSED USE: )6SGL FAMILY DWELLING
<br />o COMMERCIJ\L
<br />
<br />OWNER'S NAME
<br />
<br />PHONE
<br />
<br />-7M -(.;? '~7
<br />
<br />JOB ADDRESS
<br />
<br />LEGAL DESCRIPTION: LOT(S)
<br />
<br />BLOCK
<br />
<br />SUBDIVISION
<br />
<br />Ck/ tbk K/(V-j(1l tJ).{J
<br />
<br />PARCEL ID #
<br />
<br />(OBTAt~ FROM PROPERTY TAx NOTICE)
<br />
<br />o ADDITION
<br />
<br />OJ\LTERATION
<br />
<br />o REPAIR
<br />
<br />tJ iNSTALL
<br />
<br />o DEMOLISH
<br />
<br />OMULTI - FAMI L Y
<br />
<br />On OF UNITS
<br />o SWIMMING POOL
<br />
<br />d MOBILE HOME
<br />o OTHER
<br />
<br />o INDUSTRIJ\L
<br />
<br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL
<br />DESCRIPTION OF WORK .J Jr..v C(.r.~1rvc.1"z<.r-'\
<br />
<br />BUILDING SIZE
<br />
<br />SQUARE FOOTAGE
<br />
<br />\1.970
<br />
<br />HEIGHT
<br />
<br />RESIDENTIJ\L:
<br />COMMERCIJ\L:
<br />
<br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS
<br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY
<br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
<br />
<br />~ BUILDING
<br />~ ELECTRICAL
<br />e PLUMBING
<br />o MECHANICAL
<br />
<br />$ Qo,ooo
<br />d-oo
<br />
<br />& (1) SET ENERGY FORMS.
<br />
<br />FO~~
<br />
<br />PERMITS REQUESTED .~ IJL6 ~
<br />VALUATION OF TOTAL CONSTRUCTI~'~ 0
<br />
<br />AMP SERVICE
<br />
<br />r
<br />
<br />FLORIDA POWER
<br />
<br />o
<br />
<br />W.R.E.C.
<br />
<br />$
<br />
<br />o GAS
<br />
<br />o ROOFING
<br />
<br />o SPECIALTY
<br />
<br />VALUATION OF MECHANCIAL INSTJ\LLATION
<br />o OTHER
<br />rt FRAME
<br />
<br />o STEEL
<br />
<br />o OTHER
<br />
<br />TYPE OF CONSTRUCTION: 0 BLOCK
<br />
<br />FINISHED FLOOR ELEVATIONS
<br />
<br />IS PROJECT IN FLOOD ZONE AREAO YES ~ NO
<br />
<br />'!"I:::::::::::'::'::'::::::::::m:::::m:""::/"!':"M'!I:.:m:."::J""ll:'C:"i:ill!::"::'!~'i":"p' -- -- - - - u n lm::.,::c:::~:rn"i"'I:"":I"'II'::II:'::C::':::"lll::'I:mmm",:'mi:::":::l':::':""::'::':':II'1"'
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<br />........,..,....................,......,.......:... ltll......,I.I.I...LI.,..,..,.,..,......,."....,.n .......1.................,...................,..:.........,....1.............,'....../.....,.:....,..
<br />iJi..,......""..................""..................lli .~...... .......... ......... ........."" . ....u..~ ~. . _ ... ~...... .......n.........................,u~............u.............,......... ........t."'.. ...... "
<br />
<br />SIGNATURE
<br />
<br />
<br />**************************************************************** *
<br />
<br />
<br />COMPANY FL<:-COASS li-:b ...:~
<br />STATE CERT OR REGIST # E c.: c::bJo.;::?S7 cJ
<br />CITY PROCESSING # / <I .........&,<.
<br />
<br />*******************************************~********
<br />
<br />
<br />BUILDER
<br />
<br />PLUMBBR
<br />
<br />COMPANY
<br />STATE CERT OR REGIST
<br />CITY PROCESSING #
<br />
<br />* I:!*******
<br />
<br />
<br />YBCIIAR:ICAL
<br />
<br />SIGNATURE
<br />
<br />COMPANY
<br />STATE CERT OR REG I ST n If h1 06 J
<br />- CITY PROCESSING" ~ ~ c:20G
<br />
<br />*******************************~~*****
<br />
<br />
<br />OTHER ~-'
<br />
<br />SIGNATURE
<br />
<br />COMPANY "111/1 h~ ~.
<br />STATE CERT OR REGIST #
<br />CITY PROCESSING #
<br />
<br />*****************************************************************
<br />
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