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<br />APPLICATIOllil FOR PHRtrJ."il" <br />CITY OF ZKl'HI'KH I U,,S <br />BUll.DIliG DEPAR'IKf!:lIilT <br /> <br />OWNER'S MAIfE t{~ ~I t-AQ~. WI\LtOYL~ PIIONE~g 3 ~ (002 q <br />OWNER'S ADDRESS ~ \ 13 (L~ 4 V1/\ C2.- ~ K ~ 102- La <br />JOB ADDRESS 0 eil 0 } ';z.. .~ i2-O s:r-~ 1 <br /> <br />. LEGAL DESCRIPTlOl!I: LOI'(S) <br /> <br />BLOCK <br /> <br />_SUBDIVISION <br /> <br />PARCEL I. D.I <br />WORK PROPOSED:_J!ev Construction ~tion _Alteration -1'--Rep3ir _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />_KIF <br /> <br />_, of Ufnits <br /> <br />_K/H <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Stria. Pool <br /> <br />Ot:her <br /> <br />_Rest:aurant &- Hp.a1t:h ~t Approval <br /> <br />BUILDIIfG SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height: <br /> <br />RESIDEIfTIAL : <br />COHKERCIAL : <br /> <br />A'l'TACH (2) PLOI' PIAlIIS &- (2) SEIS OF BUILDDlG PLAJlS &- (1) SEI' ENERGY FORKS. ** <br />ATI'ACH (3) SEI'S OF RUlJ..1)DG PLAIIS &- (1) SEI' mmRGY FORKS. ** <br />**COPY OF CONTRACT RIlQlDIRIID. <br /> <br />PERlPlTTS REQUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />/g 0~. lltf <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AIIP Serrice <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---1fECIIAIfICAL <br /> <br />$ <br /> <br />__Valuation of Mechanical Installation <br /> <br />_PLUKBIlfG GAS lIDOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTIOllil: _Block _FraIIe _Steel <br /> <br />Ot:her <br /> <br />FllIISHED FLOOR ELEVATIOllilS: <br /> <br />FT. <br /> <br />IS PROJECT DI FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************.* <br /> <br />BUILDER <br /> <br /> <br />CO!tPANY M.. <br />Stat:e Cert. or Reg1st. I <br />City License Registrat:ion' <- :~2~ <br />.*********************************** <br /> <br /> <br />ELECTRICIAN <br /> <br />CO!tPMiY <br />St:are Cert:. or Regist. 1= <br />City License Regist:ration I <br />****************************************** <br /> <br />Sismat:ure <br /> <br />PIJJKBER <br /> <br />CO!tPANY <br />St:ate Cert:. or Regist:. I <br />City License Registration f <br />*********..**.****.***t*v*t********v*****~ <br /> <br />Signature <br /> <br />KECIIAlUCAL <br /> <br />CO!tPAMY <br />St:ate Cert. or Regist. I <br />City License Registration I <br />****************************************** <br /> <br />Signature <br /> <br />OTIIF.R <br /> <br />CO!tPANY <br />State Cert:. or Regist:. 1= <br />City License Registration I <br />****************************************** <br /> <br />. <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />