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<br />APPLICATION FOR PHRKIT <br />CITY OF z.II:PIIIKH II.Le:; <br />BUII.DDlG DEPAKI1IUJ'RT <br /> <br />OWNER'S IIA!tE f (J fr rr Err <br />OWNER'S ADDRESS '0570"0 <br />JOB ADDRESS S,If HE <br /> <br />G ,4}.).. u /J <br />IIJ?/VJ:~Y <br /> <br />PIIOIiE <br /> <br />7ffc"~ C;/// <br /> <br />LEGAL DESCRIPTImi: UJI'(S) <br />PARCEL I. D. t fiC-'C' !\ /11 <br /> <br />WRK PROPOSED:_rlev Construction ~tion _A1teration ~epair .../ Install <br /> <br />1,\" <br />fJit G'f! <br /> <br />1lLOCK__SUBDIVISIOlli !JAr If IF)).. <br />7 D I) 1- - r'G 3 - I? ;). / F <br /> <br />O/V/T t:I"/ <br /> <br />_Sign <br /> <br />_Move <br /> <br />_DeIIo1ish <br /> <br />PROPOSED USE: <br /> <br />Single Faai1y .> _KIF <br /> <br />_, of tlJnits <br /> <br />_K/H <br /> <br />_~rcia1 <br /> <br />_Indust. <br /> <br />_Swia. Poo1 <br /> <br />Other <br /> <br />_Restaurant &: Health ~t Approva1 <br /> <br />BUILDIlfG SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />_ RESIDENTIAL: <br />COHKERCIAL : <br /> <br />ATI'AGII (2) PLOI' PIAliS &: (2) SEI'S OF BUIlJ)DlG PLAlIiS &: (1) SET ENERGY FORKS. ** <br />ATtACH (3) SEI'S OF BUII.DDIIG PLUS &: (1) SET El!mRGY FORKS. ** <br />**roPY OF roRTRAC'J" BDlm:RED. <br /> <br />PIlmII'I'S REOUESTED <br /> <br />_BUILDING <br /> <br />$~ <br /> <br />-Ya1uation of Tot:a1 Construction <br /> <br />_ELEC'J"RICAL <br /> <br />A!IP Service <br /> <br />F10rida Power CorP. <br /> <br />W.R.E.C. <br /> <br />_tlEalAlITCAL <br /> <br />s <br /> <br />Ya1uation of Kecbanica1 Inst:a1lation <br /> <br />_PL1DtBIJiG GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF roBSTRUCTIOR: _B1ock ~ __Stee1 <br /> <br />Other <br /> <br />FIIIISIIED FLOOR ELEVATIOBS: <br /> <br />FI' . <br /> <br />IS PKOJRCT IN FLOOD ZONE AREA? <br /> <br />YES BO <br /> <br />****************************************** <br /> <br />OOIfI'RACIOR SECTION <br /> <br />RIITTDF.R <br /> <br /> <br />HI 'J-To;Y <br />St:ate Cert. or Regist. , <br />City License Registration , <br />*****.************************************ <br /> <br />COItPANY <br /> <br />~ O/f/.<{'r, <br /> <br />Signature <br /> <br />Simlature <br /> <br />COItPABY <br />St:ate Cert. or Regist. , <br />City License. Registration t <br />.*.***a*********************************** <br /> <br />ELECTRICIAB <br /> <br />COItPMiY <br />State Cert. or Regist. , <br />City License Registration I <br />****************************************** <br /> <br />PLDIBER <br /> <br />Signature <br /> <br />COItPMff <br />St:ate Cert. or Regist. I <br />City License Registration I <br />. <br />*******~********************************** <br /> <br />ftECHAJlICAL <br /> <br />Signature <br /> <br />COItPAfi <br />St:ate Cert. or Regist. :f <br />City License Registration , <br />*********************.*****~************** <br /> <br />OTIIF.R <br /> <br />Signature <br /> <br />APPLICATIOB APPROVED BY <br /> <br />PERKIT OFFICER. <br />