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<br />APPLICAYI05 FOB PIOOfiT <br />CI'IY OF ZEruumu.L:i; <br />Brru.n:f1iG DEPAR'DIE'.NIT <br /> <br />OWNER'S ADDRESS <br /> <br />h "'^\ Ie. , '-(' tJ <:>!I. \J I ~ "-' ......;. 31:>' - ri,::>':l- d-/J<t <br />n . f) ~ Or r----;). r Ivf' <br />I ~ 4 \.. I tJ V v. ~ I\' 0 11 A \ L'1 R..l? ss <- r 0 nvU J A ~ f\'\ 5) IV\ J...- Y. g:J.. 2>'- <br />'~<64-~4 ~R Slf &s.t <br /> <br />~.UJ srmDIVISI05'{J.:II~ &,t,Py eo. lv:,oJS <br /> <br />;< 1- ~,,- ();;L - 00 /. 0 - Oint), 0 (J - ()f)~ I 0 <br /> <br />OWNER'S HAIlE <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: I.DI'(S) <br /> <br />PARCEL I. D. f <br /> <br />h'URK PROPOSED:_lIew Construction -1\ddition _Alteration ARepair _Inst:all <br /> <br />S' <br />- 19I1 <br /> <br />_Move <br /> <br />_DeIIolish <br /> <br />PROPOSED USE: <br /> <br />Singl.e Faaily h _KIF <br /> <br />_, of Units <br /> <br />_K/H <br /> <br />)< ~rcial <br /> <br />_Indust. <br /> <br />_Swf.. Pool <br /> <br />Other <br /> <br />_ReS1:aurant &: Hea1t:h De)lart.ent Approval <br />BUILDIRG SIZE: mx h~. ~ 7 '7 0 6 Square Feet, <br /> <br />Height <br /> <br />. RESIDENTIAL: <br />COHKERCIAL : <br /> <br />A1'TACH (2) PLOJ' P.I.AliS &: (2) SEI'S OF BUIIJ)IRG PLUS &: (1) SET ENERGY FORKS. ** <br />ATTA.CH (3) SEI'S OF BUIIJ)DG PLUS &: (1) SET mmRGY FORKS. ** <br />*'A'COPY OF CONTRA.cr RIIQfHRIID. <br /> <br />ftJ:BJ!IITs REOUESTED <br /> <br />_BUILDIRG <br /> <br />$ <br /> <br />Valuation of Tot:a1 Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />--.JIECHAIUCAL <br /> <br />$ <br /> <br />Va1.uation of Kechanical Inst:allat:ion <br /> <br />'_Pl.UKBIliG <br /> <br />GAS <br /> <br />ROOFlliG <br /> <br />SPECIALTY <br /> <br />TYPE OF CO:NSTRUCTIOli: _Block _Fra.e _Steel <br /> <br />Other <br /> <br />FllIISIIED FLOOR ELEVAITOliS: <br /> <br />FT. <br /> <br />IS PRO.JEcr IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES :NO <br /> <br />COW'I'RAcmR SHC'fION <br /> <br />BUTT J)ER <br /> <br />CO!IPMY <br />S1:ate Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />RT.F..cTRICIAtI <br /> <br />CO!IPMY <br />S1:at:e Cerl:. or Regisl:. I <br />City License Registration f _ <br />****************************************** <br /> <br />Sim,,,ture <br /> <br />PLUKB~ <br /> <br />CO!IPMiY <br />State Cert. or Regist.' <br />City License Registration f <br />****************************************** <br /> <br />Signature <br /> <br />KEafAJlTCAL CO!IPMY <br />S1:ate Cerl:. or Regisl:. " <br />Signature City License Registration I <br />. <br />*******~********************************** <br /> <br />--"'" /,- /1./.' ,,'" r <br /> <br /> <br />I!DIlm "/ ~~~_~ =~i:: :;~:~s:~ ?t-e1~~u~~ <br /> <br />!)ignature~.u~-:::X_J'~ ' \ ~ City License Registration ., <br />~/ . ****** ..********************************* <br />,-,/ <br /> <br /> <br />WPLICAnOIi APPROVED BY <br /> <br />PERKIT OFFICER. <br />