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<br />APPLlCA'flON FOR PERtl1 T <br />CITY OF Z~PllYRlnLI.S <br />8UILDING D~PAR1MENT <br /> <br />Al'PLlCANT <br /> <br />flee /lLl1rJ'J .' <br />ADDRESS ..)J1StfS"" Pli-LIVl G/@;$ J}R. <br />OWNER /}I?TflU R- l?A L EflJAPJtI <br />JOB LOCATIONk7F3f haJI ZEI'II<< /?JI)(;,€ j);e. <br /> <br />PIIONE ref;). ~;;J.~/t. <br /> <br />. ~ <br /> <br />LOT SIZE~X/~O AREA SQ. FT. ;7J1dP <br /> <br />LEG.^ f. DESeRl PTlON: LOT (S) <br /> <br />BLOCK ,-_ SUBDIVISION <br /> <br />PARCEL I.D./~ ~/- ;)b...PJ -O/Jb - tPt'tJIPo- ~jl/~ <br />WORK PROPOSED: ~ew Construction _Addition _Alteration <br /> <br />_Repair <br /> <br />_Install <br /> <br />_Sign/Temp. <br /> <br />_Sign <br /> <br />_~tove <br /> <br />_Demolish <br /> <br />PROPOSED USE: _Single Family <br /> <br />_H/F <br /> <br />_/~ of Units <br /> <br />._M/II <br /> <br />_Commercial <br /> <br />_lndu6t. <br /> <br />_Swim. Pool <br /> <br />Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />UUILDING SIZE: ':;0 X 7 x;J1J <br /> <br />/1/0 Square Feet, <br /> <br />9 '.,." r:P ' <br /> <br />IIci~hl <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY fORtIS." <br />cmIHERCIAL: A'l'TACII 0) SETS OF UUILDING l'l.ANS lit (1) SI::'1' ENl!:RG't I~OIUlS.u <br />uCOPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REQUESTeO <br /> <br />'/8UILDING <br /> <br />$ <br /> <br />.Jlfr~()lJ <br /> <br />Valuation of Total Construction <br /> <br />__El.ECTRICAL <br /> <br />AttP Service <br /> <br />Florida Power Corp. <br /> <br />_\l.R.E.C. <br /> <br />~_MEClIANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />~PI.UMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />.; <br /> <br />TYPE OF CONSTRUCTION: _Block _Frame _Steel <br /> <br />Other' <br /> <br />flNISllED FLOOR ELEVATIONS: FT. <br /> <br />.\H!l.LDfR <br /> <br />. , <br />,L7At/ ^ ***********........*.******.****.**..**.** <br />,.." 7 ,,/9;f//ELS' , <br />i!1 "'.' ~ 4 j .~ Nt COt-lTRACTO~ SECTIOti /'1 - M <br />/7c-v. '7~nl'" Conapuny a...c.Ja ~H/"I. <br />~'~ I <br />~ ~', StaFe Cert. or Regist. # <br />. ~ . City License Registration # <br />~.************'*'*'****~'**'*'.'*H'*****" <br /> <br />Signature <br /> <br />.F.:LECTRTClAN <br /> <br />Company <br />State Cert. 01' Regist. It C/2...CL>...:?y~t5'~ <br />City License Registration I~ /~ <br />********..*...*....***.***.**.*.********** <br /> <br />Signature <br /> <br />Company <br />State Cert. o' Resist. # <br />City License Registration # <br />**.*.***.t**.**...****.***.*.****....*..*. <br /> <br />fLl)HB ER <br /> <br />.~tnature <br /> <br />Signature <br />... <br /> <br />Company __, <br />StaLe Cert. or ReGist. # <br />City License Registration # <br />...*......*..*.....*.*...*.***.*.*..*..... <br /> <br />tlECIIAtilCAI. <br /> <br />Signature <br /> <br />Company <br />State Cert. or Resist, # <br />City License Registration # <br /> <br />OIliER <br /> <br />*.*.......*.........***..**....**....*.*.* <br /> <br />APP~ICATION APPROVED BY <br /> <br />PERM1T OfFICER. <br />