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<br />APPLICATIOR FOR PERKlT <br />CI'IY OF ZEPllYRllILLS <br />BUILDlliG DEP~ <br /> <br />OWNER · S <br /> <br />lWfE UU 0 i~o77e~ <br />ADDRESS 6615 /l)1 I \~y Ie ~ <br />I') /2 3 9-fff .5"7 <br /> <br />{3_~ S/UAf T <br />z - )ii/s' <br />:~ ilL/I.) F~ <br /> <br />PIIOU ' <br />FV <br />AI' <br /> <br />7g'A-~ r;f;30 <br /> <br />OWNER · S <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: WI'(S) <br /> <br />BLOC({ <br /> <br />SUBDIVISIOR <br /> <br />PARCEL I. D. f <br /> <br />WORK PROPOSED:_Rev Construction ---..Addition _Alteration <br /> <br />_Repair <br /> <br />~Inst:all <br />~)/ae II~~ <br /> <br />_Sign <br /> <br />_!!love <br /> <br />_Deao1ish <br /> <br />PROPOSED USE: <br /> <br />Singl.e Faai1y <br /> <br />_"IF <br /> <br />_, of Units <br /> <br />_K/H <br /> <br />_<=<-ercial. <br /> <br />_Indust. <br /> <br />_SwI.. Pool <br /> <br />Other <br /> <br />_:Rest:aurant &: Hea1t:h nepan:.ent Approval. <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height: <br /> <br />RESIDEHTIAL: <br />COHHERCIAL : <br /> <br />ATTACH (2) PLOI' PLARS &: (2) SETS OF BUILDING PUNS &: (1) SET ENERGY FORKs.u <br />ATI'ACH (3) SETS OF BUTI.DDiG PLUS &: (1) SEt' ENERGY FORKS. ** <br />**COPY" OF CONTRACI' KIlJ!fITllED. <br /> <br />PERIPIITS REOOESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Val.uatioo of Tot:a1 Construction <br /> <br />_ELECTRICAL <br /> <br />AftP Service" <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_HECHANICAL <br /> <br />s <br /> <br />Val.uation of Hechanical. Installation <br /> <br />..K..PLUHBTNG GAS ROOFlliG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTIOR: _Block _~ _Stee1 <br /> <br />Other <br /> <br />FIIiISBED FLOOR ELEVA.TIONS: <br /> <br />FI' . <br /> <br />IS PROJECI' IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CORTRACIOR SECI'ION <br /> <br />CO!tPMUY <br />State Cert:. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />ELECTRICIAN <br /> <br />COIIPARY <br />State Cert:. or Regist:. , <br />City License Registration f <br />****************************************** <br /> <br />SiPllature <br /> <br />PLDtBER <br /> <br />lDIPARY CItIZ/s /3#(( /~~ Uf/flb ,,(/6 <br />Cj~k.tf/Jn::5 W Sta<e ~<. or R~is<. .. I< ro >0 <11.['1 f5 <br />~~ '1 C1t:y L~Lceose Reg:I.st:rat::I.on I (I)? <br />***********************a-****************** <br /> <br />Signature <br /> <br />CO!tPANY <br />State Cert. or Regist. I <br />City License Registration f <br />****************************************** <br /> <br />KECHMfICAL <br /> <br />Signature <br /> <br />CO!IPARY <br />State Cert:. or Regist:. It <br />City License Registration f <br />****************************************** <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKlT OFFICER. <br />