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<br />APPLICATION FOR PERMIT <br />CIT~ OF ZEPn~RHILLS <br />. BUILO!NG DEPARTMENT <br /> <br />DATE RECEIVED_ <br />PLANs RE'V:rEW FEE <br /> <br />OWNER'S NAME +:v ~fr,clt:t . <br />JOB ADDRESS-kON &'1/1, -)!;~;:;-: <br /> <br />LEGAL DESCRIPTION: <br /> <br />PHONE <br /> <br />PARCEL ID # <br /> <br /> <br />BLOCK <br /> <br />WORK PROPSED: (JNEW CONSTRUCTION <br />(J SIGN <br />PROPOSED USE: ~GL FAMILY DWELLING <br />(] COMMERCIAL <br /> <br />SUBDIVISION <br /> <br />DESCRIPTION OF WORK <br /> <br />o ADDITION DALTERATION ~EPAIR o INSTALL <br />(] MOVE 0 DEMoLISH <br />OMrILTI - FAMIL Y D# OF UNITS (J MOBILE HOME <br />o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />3 <br /> <br />BUILDING SIZE <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />ATTACB (2) PLOT PLANs · (2) SETS OF BUILDING PLANs . II} SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS. II} SET ENERGY FORMS. <br />PROPERTY SURVEy REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />HEI GHT _ <br /> <br />(J BUILDING <br />o ELECTRICAl, <br />(J PLUMBING <br />o MECHANI CA.L $_ <br />o GAS 9rROOFING 0 SPECIALTY <br /> <br />$~475 <br /> <br />PERMITS REQUESTE~ <br /> <br />-- VALUATION OF TOTAL CONSTRUCTION <br /> <br />- AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C.. <br /> <br />-- VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />(] FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS _ <br /> <br />Is PROJECT IN FLOOD ZONE MEAD YES 0 NO <br /> <br /> <br />~UILD~ <br /> <br />SIGNATURE <br /> <br />.................................................................. <br /> <br />COMPANY_ <br />STATE CERT OR REGI ST # __ <br />CITY PROCESSING ~ <br /> <br />~LECTRICI~ <br /> <br />SIGNATURE _ <br /> <br />.................................................................. <br /> <br />COMPANy_ <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />g~ <br /> <br />SIGNATURE <br /> <br />~ClIAN:r~ <br /> <br />..........~....................................................... <br /> <br />COMPANy- <br />STATE CERT OR REGI ST # __ <br />CITY PROCESSING # <br /> <br />OTHER <br /> <br /> <br />................................................................. <br /> <br />COMPANy_ <br />STATE CERT OR REGIST # __ <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />nGNATURE <br /> <br />........................................................,..,..... <br /> <br />COMPANCf1!t;prl'1 (' nYJ"iIn:{ (1iJnn, Jnc. . <br />STATE CERT . R 'REGI ST # -c (' r. . / )~;;;;, {.i.t) ") <br />CITY PROCESSING # eX;... 7 <br />