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<br />AP1'L!CATlON FUR l'l::IUI1T <br />CI'l'Y OF Z~P1\YHIIILI.S <br />UUILDING DEPAH1~ENT <br /> <br />Al'Pl.ICANT <br /> <br />IJcE <br /> <br />ADDRESS J?~9S- cP/lL/Y) t:!RlJtfE LJ/2. <br />;::'"/e JlftJCI,S J?'I /119 S s <br />. <br /> <br />JOB LOCATIONJ"r-/S" ~jtl/ ~IIYt' RJfJ(;,.E:, ,/);<. LOT'SIZE'S- ~ AREA SQ. fT. J>:;~ <br />U:G.i\ I. OESf.RIPTlON: LOT(S) ~ BLOCK ~h SUBDIVISION ':;/ - ~/3~- t:XJCJCV _ CJ/S-O <br /> <br />f)4fJY] . <br /> <br />PHONE <br /> <br />7?~.. ~6/k <br /> <br />OImER <br /> <br />l~ARCEL 1,0, /1 <br />\WRK PROPOSED: ~w Construction <br /> <br />_Additior: <br /> <br />____Alteration ____Repair <br /> <br />_Install <br /> <br />_Sign/Temp, <br /> <br />____Sign <br /> <br />_Nove <br /> <br />_Demol ish <br /> <br />PROPOSED USE: ~Single Family <br /> <br />_H/F <br /> <br />____/J 0.. Units <br /> <br />._tl/ H <br /> <br />_Commercial <br /> <br />_lndu6t. <br /> <br />_Swim. Pool <br /> <br />Other <br /> <br />_Restaurant & Health Pepal'tment Approval <br /> <br />IIIH UH HG SlZE I /..:l ~. <br /> <br />~:J 2.. <br /> <br />S<Jual'C Feet_ <br /> <br />9 "7'0 .P . <br /> <br />lIeighl <br /> <br />RESIDENTIAL: ATTACII (2) Pl~T PLANS & (2) SETS OF lIUILDING PLANS & (1) SET ENERGY fORMS." <br />COtltlt::KClAI.: A'l''fACIl (3) SETS OF DUILDING l-I.ANS & (I) SET ENt::RGY I~ORtlS." <br />.*COpy OF CONTRACT REQUIRED. <br /> <br />PE:RMITS REQUESTf.Q <br /> <br />_UUILDING <br /> <br />$ <br /> <br />4/~~ ,DO <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AHP Sel'vice <br /> <br />Florida Power Corp. <br /> <br />__H,R,E.C, <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />~PI.UHBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />'1';1'1:: OF CONSTRUCTION: _Block vframe _Steel <br /> <br />11-!-1I1'1. <br /> <br />Other' <br /> <br />f'INISIIEO FLOOR EI.P.VATTONS: FT, <br /> <br />. , <br />....*..................................... <br /> <br />.\lU.lLUFR <br />. <br /> <br />,; CONTRACTUR SEG'llON 9CI!F <br />-~ nlll~. C ~'LIL~ <br />~ ~ ~.., ompuny ~, -~'. <br />/~/2~ '/1 Sta~e Cert. or Regist, II C~CC .:?~bPD <br />t-U~J City License Registration II /~t!J <br />.*.....~...............,.........~........ <br /> <br />Signature <br /> <br />~LECTRTCIAN <br /> <br />Company <br />State Cert, or Regist, II <br />City License Registration II <br />.,........................................ <br /> <br />SillnijtlJre <br /> <br />rLmlflER <br />~~tnature <br /> <br />Company <br />State Cert. 0' Regist. II <br />City License Reaifitration II <br />...................................,,-.... <br /> <br />~lfcllANl CAT. <br /> <br />Company <br />State Cc~t, or Resist. II <br />Ci ty I.iccnse Heslstnrtiol\ IJ <br />...~.........*......*...........*..*...... <br /> <br />Sigllature <br />.. <br /> <br />QTliER <br /> <br />Company . <br />State Ce~t. or Regist. II <br />City License Registration II <br /> <br />Sigrtature <br /> <br />.......................................... <br /> <br />APl'pCATION APPROVED BY <br /> <br />PERttlT OffICER. <br /> <br />'. <br />