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<br />APPLICATIOK FOR FERKIT <br />CITY OF ZEPJIYRHI.U.S <br />BUTI.DTIiG DEPARIHIJXT <br /> <br />OWNER'S NAKE f( uTH s TE i/ €"# ~ <br />OWNER'S ADDRESS ~ct;l G, C./l..(MA~ <br />JOB ADDRESS ~F'J- b 6~~~ <br /> <br />mONE 7f'2-ff-7Y <br />'2~~/ V. 33'5-9"1 <br /> <br />LEGAL DESCRIPl'IOI!I: I.DI'(S) <br /> <br />BJ..OCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D. t <br /> <br />WORK PROPOSED:_IIev Construction _Addition _Alteration _Repair _Install <br /> <br />S' <br />- 19D. <br /> <br />_lIIove <br /> <br />_Deao1ish <br /> <br />PROPOSED USE: <br /> <br />Single Faai1y <br /> <br />_KIF <br /> <br />_' of Ufnits <br /> <br />_K/H <br /> <br />_~rcia1 <br /> <br />_Indust. <br /> <br />_S~. Pool <br /> <br />Other <br /> <br />_Rest:aurant &: Hea1t:h ~t Approva1 <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: A'l'TACH (2) PLOI' PLAliIS &: (2) SEI'S OF BUlLDIKG PIJ\NS &. (1) SEl" ENERGY FORMS. u <br />COHKERCIAL ': ATl'ACH (3) SEI'S OF B1ITI.DDG PLMiIS &: (l) SET ENERGY FORMS.'u <br />. **copy .OF COMUCT ~UIRED. <br />;(7~ ~e;.~~~...~c. ~-d /V~-/..l. #~ <br />A:',;?-<....) D rS-c,=>...v./Ve.-u /1t- A7 c . PERl![[TS REQUESTED <br /> <br />_BUILDING $ Va1uation of To~ Construction <br /> <br />_ELECTRICAL <br /> <br />~ Servic.e. <br /> <br />F10rida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_!tECHAlfICAL <br /> <br />$ <br /> <br />;,.___~~a1uation of Kecbanica1 Installation <br />.. . " <br /> <br />_PLUKBING <br /> <br />GMt. . c; <br /> <br />KOOFllIG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fra8e _._Stee1 <br /> <br />Ot...her <br /> <br />FTI(~SBED FLOOR ELEVATIONS: <br /> <br />FI' . <br /> <br />TS.P:ROJECT IN FLooD ZONE AREA? <br />7. -~ <br /> <br />YES NO <br /> <br />*****************~~********************** <br /> <br />ClWTRACIOR SECTIOIr' <br /> <br />CO!tPANY <br />St:ate Cert. or Regist. I <br />City License Registr~tion , <br />....*.~...**..*.*~.****~.~~~*********.t~.~ <br /> <br />BUILDJ:R <br /> <br />Signature <br />. .- t <br /> <br />~CIAN. , ~ IDIPARY a~/(...:~' <br />~.. Y State Cert. or Regi t. iii <br />Si tu .> ~A 1--. City License Regist':.:.ation , <br />,~. ****************.*~********************** <br /> <br />PIDtBER CO!tP.DIY <br />St:ate CeTC,.or Regi~t. I <br />Signature City Lic~~~ Registration , <br />**************************~!~************* <br /> <br />KEalANICAL ., ~ OO1IPANY ~i&l..,:; <br />~ ~ ~/ /ji St:ate Cert. or Regrst. ., <br />Signa . '3/(// /1 ,/ ........-. ~ City LiceJUiJ; Regi~tration , <br />**************~.***********~.***.******** <br /> <br />OO1IPABY <br />State CerL-:~or Regist:. :f# <br />City License ~egistration , <br />*..*.~~~**~****..************************* <br /> <br />~ <br /> <br />Si....blft <br /> <br />APPL:iCArlO.'AP~ BY <br />'.~~~:'~',,:". "tw., .~.\./..~. <br /> <br />-~ <br /> <br />PERKIT OFFIC~. <br />