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<br />APPLICA'n01!il FOR PERKiT <br />GI'lY OF ZEmYRHIUS <br />BllJIIJ)I1!iIG DEPARDIEJfr <br /> <br />/ <br /> <br />OWNER'S NAKE M;;~D/V /l~>P~k/:Jffd'6E;e <br />OWNER'S ADDRESS S;-7 {;) l' - (3 S71('~ /V; <br />JOB ADDRESS -::-7 D '7 -- (:7 .s?7t'~.-:r //' <br /> <br />PIIOH 7r3 -- /7 J S- <br />-1--E/~ ~ /tf~ , /::::-c::..3 "'?,S-V (j <br />( <br /> <br />LEGAL DESCRIPTIOl!i: UJI'(s) <br /> <br />BI.OCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D.I <br /> <br />WORK PROPOSED:_IIew Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />_KIF <br /> <br />_, of lJJnits <br /> <br />_K/H <br /> <br />_~rcial <br /> <br />_Indost. <br /> <br />_Swia. Pool <br /> <br />Other <br /> <br />_Restaurant &: Hea1t:h Deparblent Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height: <br /> <br />RESIDENTIAL: Al'TACH (2) PLOI' PI.AIiS &: (2) SEIS OF BUILDING PI.ANS ~ (1) SEI' ENERGY FORKS. ** <br />COttttERCIAL: ATI'ACH (3) SILTS OF BUII.DDiG PLDlS &: (1) SEI' E1!iIERGY FORKS. 'H: <br />**OOPI' OF OONTRACT RllQUIRED. , / <br />(VG?u ~?4-t'C- ~ y:z. ~'~ 7/"'~ r c.,.5~ - I /ff~ <br />/~/O~ ~ '7 I <br />~/vt<.J . /Sl)~ ~~ PERKTTS REO TED <br />j;J.. -: Dr ~c<.;;.oJ~U-v' <br />_BUILDING $ Valuation of Tot:a1 Construction <br />S-" .>-:;: <br />~ELECTRICAL />0 AtIP Seryice- Florida Power Corp. W.R.E.C. <br /> <br />~HECIWilCAL <br /> <br />s ~f~O.!:;- <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLlJKBING GAS ROOFDiG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _~ _Steel <br /> <br />Ot:her <br /> <br />FniISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE ARFA? <br /> <br />YES NO <br /> <br />**********************~~****************** <br /> <br />OOWI'I'RACIOR SECTION <br /> <br />COKPMIlY <br />State Cert. or Regist.1 <br />City License Registration I <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />ELECI'IlICIAN ~ <DIPAIIY Ah ',t'z::.r1"" ~HC. <br />~ ' Sta'" Cert. or Regist. f br <br />SiJ!D.3t e ~/ I City License Registration I <br />, ****************************************** <br /> <br />ot) 1:2- 1)<) 5..... <br />.:2,5''- <br /> <br />COIIPDY <br />State Cert. or Regist. I <br />City License Registration I <br />**~~****..******************************** <br /> <br />PumBER <br /> <br />Signature <br /> <br />KEaJAlUCAL ~ COIIPAHY ffi ~o Vp. ","iN &- <br />~ / /J ;(....-Y/ State Cert. or Regist. I 1:4 F#- C A ;t9" Y <br />Signa a-Ct;Y L--~ City License Registration I II tj <br />- ****************************************** <br /> <br />0'nIF.R COIIPABY <br />State Cert. or Regist. I <br />Signature City License Registration I <br />****************************************** <br /> <br />APPLICATION APPROVI!'D BY PERKIT OFFICER. <br />