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<br />APPLT.r'AfiOB JrOR PERKIT <br />GI'IY OF ZJ!PIIYJmILLS <br />BUII.DIBG DEPAImItEBT <br /> <br />OWNER t S RAKE <br /> <br />}-JA" 0 J--!S BAf0\L <br /> <br />FIIOB <br /> <br />OWRER t S ADDRESS C/o <br /> <br />Sb::;?.-- 2- &A II e:.uJD <br /> <br />2.:::i~H'f~ t'\ (lIs. <br /> <br />JOB ADDRESS <br /> <br />~ e-,,:-> 2- <br /> <br />&~-L_ i2..(:::' <br /> <br />LEGAL DFSCRIPTIOIM: UJI'(S) <br /> <br />~SUBDIVISION <br /> <br />PARCEL I. D.' <br /> <br />Ot c -;q <br /> <br />00 lO, 0 <br /> <br />WORK PROPOSED:_lNIev Construction _Addition _Alteration ._Repair _Install <br /> <br />-'L-Sign <br /> <br />-.JIove <br /> <br />_DeIIo1ish <br /> <br />PROPOSED USE: <br /> <br />Sing1e Ftmily .. --1f/F <br /> <br />_' of Units <br /> <br />_K/H <br /> <br />_ec-ercia1 <br /> <br />_Indust. <br /> <br />_Swi8. Poo1 <br /> <br />BA"-j L <br /> <br />Other <br /> <br />_Restaurant &: Hea1th Depart.en.t Approva1 <br /> <br />BUILDDfG SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />. RESIDENTIAL: <br />COttKERCIAL : <br /> <br />AITACH (2) PLOT PLAlIIS &: (2) SE1'5 OF BUIIJllliG PI.ARS &: (1) SEI' ENERGY FORKS. ** <br />ATTACH (3) SE1'5 OF BUILDIIIG PLAlIIS &: (1) SEI' DmRGY FORKS.** <br />**mpy OF mBTRAcr RIlQUIRIID. <br /> <br />~ REQUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Va1uation of Tota1 Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />F10rida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_KECllANICAL <br /> <br />$ <br /> <br />Va1uation of Kecbanica1 Installation <br /> <br />_PLUKBIliG GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTIOlNl: _B1ock. _FraIIe _Stee1 <br /> <br />Other <br /> <br />FIlIISHED FLOOR ELEVATIOBS: <br /> <br />FT. <br /> <br />IS P.RO.JECT TIf FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />COJI'I'RAGroR SECTION <br /> <br />S ignat:ure <br /> <br />~~r <br /> <br />aJl!IPANY A+\!;CX- lG~ Sl L-:*- Lv <br />/~ St:at:e Gert. or Regist.' Ss. oo~7e) <br />~u. City License Registration" f..- IS <br />***~************************************ <br /> <br />BIJTTJ)ER <br /> <br />Sismat:ure <br /> <br />aJl!IPMfY <br />State Gert. or Regist. f <br />City License Registration , <br />****************************************** <br /> <br />ELECTRICIAlf <br /> <br />Signat:ure <br /> <br />aJl!IPABY <br />State t;.e:.:i':. or Regist:. :if <br />City License Registration I <br />****************************************** <br /> <br />PLOtIBER <br /> <br />aJl!IPArIY <br />State Gert:. or Regist:. I <br />City License Registration I <br />. <br />*******~********************************** <br /> <br />KEaJAl[[CAL <br /> <br />Signature <br /> <br />aJl!IPANY <br />State Gert. or Regist. , <br />City License Registration , <br />*****~************************************ <br /> <br />0'T1II1:R <br /> <br />Signature <br /> <br />APPLICATION APPROVFJ) BY <br /> <br />PERIIIT OFFICER. <br />