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<br />APPLICATION FOR FERKIT <br />GI'IY OF ZEPBYImII...LS <br />BIJJIIJlUG DEPARDIEKI' <br /> <br />OWNER r S 1WtE. r ~ ~ ~ y C) LU~ ~-5:> PIIONE '1 ~~ -0 ~S <1 <br />OWNER r S ADDRESS~ '-1. \ (:) G::. {\ \...... '\-J b L-v D C)S ~ ~ 'X ~ ~ \ \.,~ S. <br />JOB ADDRESS <;S \ '\... \..) i:..>?- CJ ~ ~S \) 'L \. \.J ~ <br />LEGAL DESCRIPTION: L.OT(S) ~a f\ BLOCK SUJBDIVISIOlNlS\\. ,\J't:.. 'K- <:::J ~ ~ ~ <br />PARCEL IoD.fO 3, -~\o - ~ \ - ~\~ C) ,... C)()t)~Q) ..... Dd.~~ <br />. <br /> <br />WRK PROPOSED: X lNlev Construction ~ition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_!!love <br /> <br />_Deaolish <br /> <br />PROPOSED USE: "J... Single Faaily <br /> <br />_KIF <br /> <br />~t of Units <br /> <br />_M/H <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_Swi.-. Pool <br /> <br />Other <br /> <br />_Restaurant &: Health Deparblent Approval <br />, 1\ <br />BUILDING SIZE:S~6'D . \ ~~ 5" Square Feet. <br /> <br />~ <br /> <br />I <br />\~ <br /> <br />\ Sl\)~/ <br />Height <br /> <br />RESIDENTIAL: <br />cotmERCIAL : <br /> <br />AtTACH (2) PL.OI' PLMS &: (2) SEI'S OF BUII.DING PLAlNlS &: (1) SET EliERGY FORMS. ** <br />ATTACH (3) SEI'S OF BUIl.DIlNlG PLMS &: (1) SET ENERGY FORKS. ** <br />**COPY OF CONTRACT RIlX!UIRIlD. <br /> <br />PERKI'I'S REQUESTED <br /> <br />7-- BUILDING <br />~ELECTRICAL <br />~CAL <br /> <br />$ <br />\S~ <br /> <br />$ ~a~~ <br /> <br />AMP Service <br /> <br />^ Florida Power Corp. W.R.E.C. <br />t) "'"" (:b \) <br />Valuation of Kechanical Installation a ().... \ o-r-. ...... <br />3C..>"OO P l. V <br />SPECIALTY <br /> <br />Valuation of Tot:al Construction <br /> <br />~PLUMBING <br /> <br />GAS ROOFING <br /> <br />TYPE OF CONSTRUCTIOlNl: ~Bloclt Fraae _Steel <br />M\\J- <br />FTIiISBED FLOOR ELEVATIONS :~Fr . IS PROJECT IN F'LOOD <br /> <br />Other <br /> <br />YES <br /> <br />~ <br />NO <br /> <br />ZONE AREA? <br /> <br />******************..********************** <br /> <br />C01Wl'RACTOR SECTION <br /> <br />BUILDER mMPANY_~'~ ~ ~V~~t~':E <br />h ~ <....~ State CerL or RegisL ,c.,~'C'..Irg \~'\.~~ <br />Signature \L..:>C> ~ Cit:y License Registration , .:.3...L$ <br />****** *********************************** <br /> <br />ELECTRICIAN' <br />0.. ) n~Y~ 1).1'11 <br />Simt::llt:ure ~I&~' <br /> <br />OO!tPMY t=~ S~~~\ ~\C. <br />iJ ~ S~te ~rL or R~gist. _ ' ~ \i:.~l.o y.--c\ <br />C1t:y L1cense Reg1strat1on I I <br />****************************************** <br /> <br />PLUKBER mMPMn_ C \1 ~\.L~ ~~~ ~ ~' ~c:.- <br />State CerL or RegisL' ' <br />Signature City License Registration f t d.~ <br /> <br />IfECBAJflCAL~~ t/' ~..._~;.~:.::.:~;: <br /> <br />~ k State Cert:. or Regist:. , <br />Signat:ure . 111.../'A~ e City License Registration ~ ~ <br />**** **** **************************** <br /> <br /> <br />OTHER. <br /> <br />mMPAlNlY <br />State Cert. or Regist. , <br />City License Registration , <br />*..****.***...**********.******.**~******. <br /> <br />Signature ___._ <br /> <br />APPLICATION APPROVED BY <br /> <br />/1 dAU', is X!<.VV.n, ~ <br /> <br />PERKIT OFFICER. <br />