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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARTMENT <br /> <br />r <br />f) 1 CcJ~~ (-7- 0;> K.t- <br />tp081-___ .-- --- <br /> <br />OWNER' S NAKE W ~ 1/ A/;J <br />,. <br /> <br />7iIVNt',C 7;;.,.rh~ / Rd tPIC f 4/~h,.yPHONE ;.r-..) J - / / /,,6 <br />(; i!/ / .k Iv; r 7'e ~, z ~;> ~~ ,{, '/ /.r;. F/ .i.f -"-'7 / <br />z e. ~ d I/..t:- h f' /.<r J /:- / .]> ~ S--Y / <br />f' / <br /> <br />G'?! / / <br /> <br />~/t// <br /> <br />OWNER'S ADDRESS S-J ?" -3 <br />JOB ADDRESS .c J.. .y , <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1.D.' II-j. 6 - ~/-dJ(//tJ -/S-Ytf'/t!,-t.?tf.rD (OBTAIN FROH PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition ~Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_DeJIOlish <br /> <br />PROPOSED USE: _Single Faaily <br />-Lec-ercial <br /> <br />_H/F <br /> <br />_, of Units _H/H <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: r N -I e It .' d tC <br /> <br />l> & t-'14 tf /fJ ~ '/'/ a <br />/ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_HECllAliICAL <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />r <br /> <br />FIRISBED FLOOR ELEVATIONS: <br /> <br />Fr. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />BUTT.DER ;7 <br />/-f <br />Signaturj-,;..---- <br /> <br />CONTRACTOR SECTION <br /> <br />COMPANY tTd 4 fi/ J.., ,['~ ,/, 4 ~ ~ !'If ;-L <br />~ /-:e...e(" State Cert. or Regist. . C &-c .J::"'7S-/ 7 <br />- /'C ___/~L- City License Registration' ~ 9' 9 <br />****************************************** <br /> <br />. COMPANY Fi~ C/aC;~ We.. ,(,( C <br />State Cert. or Regist. . 8e; c.JvG--5'"'7D <br />City License Registration . ) if 1:, <br />************************************** <br /> <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />HECHABlCAL <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />