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<br />APPLICATION FOR PERKlT <br />GI'IY OF ZEPIIYBIIILLS <br />BUILDDIG DEPAKDIEIilT <br /> <br />=::::RESS~~tj~- ~~ ~fVv~~(~~0 3'10l~ <br /> <br />JOB ADDRESS :) B() 7 (Q r- 5 +- L~f evl\ ~( I f <br /> <br />LEGAL DESCRIPTIOl!i: L.OT(S) <br /> <br />BI.OCK <br /> <br />_SUJBDIVISIOlNl <br /> <br />PARCEL Io D. f <br /> <br />WRK PROPOSED:_lIev Construction -...Addition _Alteration_Repair _Install <br /> <br />S. <br />- 19D. <br /> <br />_!!love <br /> <br />_De.olish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />_"IF <br /> <br />_' of Units <br /> <br />_M/H <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_Swi.-. Pool <br /> <br />Other <br /> <br />_Restaurant &: Health nepan:.ent Approval <br /> <br />BUILDIXG SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL : <br />cottKERCIAL : <br /> <br />AtTACH (2) PL.OI' PI.AliS &: (2) SEI'S OF BUILDING PLAlNlS &: (1) SET EliERGY FORMS. U <br />ATTACH (3) SEI'S OF BUIl.DlliIG PLMS &: (1) SET ENERGY FORKS. ** <br />**copy OF CONTRACT RIJX!(JlIRED. <br /> <br />PER1!IITS REQUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />Xl <br /> <br />, <br /> <br />ROOFIl!iG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIOHS: <br /> <br />FI' . <br /> <br />IS PROJECT IN FlOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />BUILDER <br /> <br /> <br />cmrI'KACTOR SECTION <br /> <br />mMPMIIY S0lAG.JL~ CW\.(+ ,~ <br />State Cer~. or deg1st. , <br />City License Registration . <br />***************************************** <br /> <br />Signature <br /> <br />ELECTRICIAN <br /> <br />COIIPMY <br />State Cert. or Regist. , <br />City License Registration t <br />****************************************** <br /> <br />SiPOature <br /> <br />mMPARY <br />State Cert. or Regist:. , <br />Ci~~ Li~~~~ Registration t <br />****************************************** <br /> <br />PUJKBER <br /> <br />Signature <br /> <br />Signa1:ure <br /> <br />mMPMY' <br />State Cert:. or Regist. I <br />City License Registration I <br />****************************************** <br /> <br />tlECllARICAL <br /> <br />aJlfPAlNlY <br />State Cert:. or Regist. I <br />City License Registration j <br />****************************************** <br />, <br /> <br />O"I"IIF.R <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />'1! d".v ~':iI/iAA 17-.'r <br /> <br />PERMIT OFFICER. <br />