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<br />APPLICATIOllil FOR PHRHIT <br />CI'IY OF ZJ!PIIYKIIILLS <br />Bm:I.DDlG DEPARnIElIilT <br /> <br />OWNER'S MAIfE LO V,j' Ev e. / "- I- <br /> ~- 2 (l} // L- ( )1- <br />OWNER'S ADDRESS '/ p , ,/ "-J <br /> /'",..... r, If f/~ F , <br />JOB ADDRESS ' ) L~:' r / !L L ( J r- <br />LEGAL DESCRIPTION: tDr(S) BLOCK <br /> <br />mon <br /> <br />jYt) - ') g~)G' <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D. t <br />WORK PROPOSED:_l8Iev Construction ~tion _Alteration LRepair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_DeIIolish <br /> <br />r-----'-----,. <br /> <br />PROm;/ID USE' ~ingle FaJLily) _!t/F <br />-_/ <br />_~rcial _Indust. <br /> <br />_, of Ufnits <br /> <br />_K/H <br /> <br />_Stria. Pool <br /> <br />Ot:her <br /> <br />BUILDING SIZE: <br /> <br />_Restaurant &- Hea1t:h ~t Approval <br /> <br />/fOb <br /> <br />r-\ <br />, ) <br /> <br />xJo, <br /> <br />Square Feet. <br /> <br />/016:; <br /> <br />Height <br /> <br />_ RESIDEIfTIAL: <br />cottKKRCIAL : <br /> <br />AT'fACII (2) PLOI' PlARS &- (2) SEIS OF BUILDING PLAJlS &- (1) SEI' ENERGY FORKS. ** <br />ATTACH (3) SEI'S OF BUILDIBG PLAIIS &- (1) SEI' mmRGY' FORKS. *..... <br />**COPY OF COIn"RACT RIlQmIUlD. <br /> <br />PERlIIITS REQUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />Z.)i()()7J <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 />s <br /> <br />Valuation of Mechanical Inst:allation <br /> <br />_PLUKBIIfG GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF COIfSTRUCTION: _Block _Fraae _Steel <br /> <br />Ot:her <br /> <br />FIlIilISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT ]]I FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />***~*********************.*******~**~***** <br /> <br />RIDTJ)F.R <br /> <br /><DI'I'RACI'OR SECTI?N . .'J 4 <br />,--- \ 1, <br />.' . . <br />,...--"/1' .- '/'> - - _ ,,' -' .. <br />c2/-.. W WIIF...... -' D t /; Jl, G , _oj <br />/_~ St:ate Cert. or Regist. I < (: <br />City License Registration , <br />y **********************z******************* <br /> <br />) <br /> <br />l~ L-; <br />ootJ Y,j~' <br /> <br />Signature <br /> <br />SiPnature <br /> <br />CO!tPMIY <br />St:ate Cert. or Regist. j: <br />City License Registration I <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />CO!tPANY <br />State Cert:. or Regist. j: <br />City License Registration I <br />****************************************** <br /> <br />PLDKBER <br /> <br />Signature <br /> <br />CO!tPMiY <br />State Cert. or Regist. I <br />City License Registration I <br />*********************************~******** <br /> <br />KEClL\lfICAL <br /> <br />Signature <br /> <br />CO!tPMiY <br />State Cert. or Regist. ,______ <br />City License Registration , <br />*******.*****~**************************** <br /> <br />OTHER <br /> <br />S ignat:ure <br /> <br />APPLICATION API'ROVIrD BY )1 '" Aj A' (j s/j, (/lAVJ::. <br /> <br />PERKIT OFFICER. <br />