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<br />APPLICATIOlSl FUR PERKIT <br />CIn OF z.ElI'IIE.UIT1.I;~ <br />BUII.DIliG DEPA'R'DIEJJT <br /> <br />-::;>-'/v/::'? . <br />L~-....(~...0(, /' .- <br />. 0-,,-,<?~ ~ UJ- <br />r:! c/ (--,~, <br />CT - 1'5 ~17~- <br /> <br />OWNER' S HAHE <br /> <br />WA L--ynl1/Z-T <br /> <br /> <br />5 rO /Z-sr, T;ucJ <br />" <br /> <br />JOB ADDRESS <br /> <br />7'1E .~ <br /> <br />C4LL. <br /> <br />/3' L I/t/ <br /> <br /> <br />OWNER · S ADDRESS <br /> <br />LEGAL DESCRIP'l'ION: IDI'(S) <br /> <br />BI.OCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D. t <br /> <br />WORK PROPOSED: V lNlew Construction _Addition _Alteration _Repair _Inst.all <br /> <br />_Sign <br /> <br />_!!love <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br />V ~rcial <br /> <br />_KIF <br /> <br />_, of Units <br /> <br />_H/D <br /> <br />_Indust. <br /> <br />_Swill. Pool <br /> <br />Other <br /> <br />_Restaurant: &: Health Depar~t: Approval <br /> <br />BUILDIHG SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL : <br />cottKERCIAL : <br /> <br />A'ITACII (2) PLOt PLOS &: (2) SEI'S OF BUILDING PLUS &: (1) SET RNERGY FORKS. u <br />ATTACH (3) SETS OF BUII.DDG PI.A5S &: (1) SET ElNERGY FURMS. ** <br />**COFY OF COm'RAGr ~1ITRIlD. <br /> <br />PElmITS REQUESTED <br /> <br />_BUILDING <br /> <br />,- 00 <br />$ ~O, 000,-- <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 />_KECIIAlUCAL <br /> <br />$ <br /> <br />Va1Wltion of Hechanical Installation <br /> <br />_PLUHBING GAS ROOFDiG <br />TYPE OF CONSTRUCTION: 'V Block _Pralle ~Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FHiISIIED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJEGr IN Fl.OOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />COURACI'OR SECTION <br /> <br />BUILDER <br /> <br />Signature <br /> <br />CDlfPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />CDlfPANY <br />State Cert:. or Regist:. j <br />City License Registration I <br />****************************************** <br /> <br />SiPn:.llture <br /> <br />PLOtIBER <br /> <br />Signature <br /> <br />CDlfPMY <br />State Cert. or Regist:. , <br />C~~ License Registration t <br />****************************************** <br /> <br />KECBAlIICAI. <br /> <br />CDlfPAlSIY <br />State Cert:. or Regist:. I <br />City License Registration I <br />****************************************** <br /> <br />Signature <br /> <br />OIlI!'iI!~' ~ OOJJPIfJJY (i,AJ) N 5 LA (A PI/'. € <br />, . State Cert:. or Regist. , 3Cj <br />Signature ~. X~~t'd~q/, ~ License Registration , <br />***. . .*.........***..*****..................... <br /> <br />5 "/5 /t-i11 'J i .J/Vc/ <br />2-(30 3ovO' I g? <br />'777 <br /> <br />APPLICATION APPROVED BY <br /> <br />PERHIT OFFICER. <br />