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<br />~t"J..i::d\nOllV FtJi( l'ERKIT <br />L'ITlt ~)F ZEm1'RIi!II.LS <br />BUIIJiUIG "DEPA.RnIf!ET <br /> <br />OWHER t S MAKE <br /> <br />Z; F. m. P A-QJp~1Z- S <br /> <br />..,........~--,-- <br /> <br />3? 33 b ~H"t,v~L1---R..lL <br />S/Jr/7 z- <br /> <br />moB <br /> <br />162- 3Soc <br />?I 335-<;ID <br /> <br />OWIIER'S ADDRESS <br /> <br />2-"','//51 <br /> <br />, <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTImI: Wr(S) <br /> <br />~SUBDIVISIOIli <br /> <br />PARCEL I.D.' <br />WORK PROPOSED:~:rIew Construction --.J'ddj.tion _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: Single Faaily <br />..:fL-ec-ercial <br /> <br />_KIF <br /> <br />_, of Units <br /> <br />_K/H <br /> <br />_Indust. <br /> <br />_Swill. Pool <br /> <br />Other <br /> <br />BUILDIliG SIZE: <br /> <br />_Restaurant &: Health ~t: Approval <br />I <br />X ,~p-O__",~Square Feet, ,~~....~ /2 Height <br /> <br />AtTAaI (2) PI..Or PLA11115 &: \:2; .sZ!S OF :.aun.DDiG FL.US & (1) SET ENER.:;Y roRMS. ** <br />ATI'ACH (3) SILTS OF BUIl.DDiG PiA!;S Ii: (1) SET El!mRGY FORKS. ** <br />**COPY OF CONTRACT RIJX!Ill]DlD. <br /> <br />RESIDENTIAL: <br />cottKERCIAL : <br /> <br />~ REOUESTED <br /> <br />-t-BUILDIIiIG <br />_ELECTRICAL <br /> <br />$ <br /> <br />ValuatiOlJ', cf Total Construction <br /> <br />~DO <br /> <br />AIf.P Se:rrice <br /> <br />Flo:cida Power Corp. <br /> <br />X W.R.E.C. <br /> <br />_HECllAfUCAL <br /> <br />$ <br /> <br />Valuation of Kechanica1 Installation <br /> <br />-PLUKBIliG <br /> <br />.--X ;ROOFTItG <br />TYPE OF COIiISTRUCTIOIi: _Block XFraIIe _Steel <br />FDIISHED FLOOR ELEVATIOIiS: 'lb. ,t(} FT . <br /> <br />GAS <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />YES <br /> <br />X <br />1iI0 <br /> <br />IS PHOJECT IN F'UY.)D ZONE AREA? <br /> <br />**********************'~******i1'************ <br /> <br />RIITT nF.R <br /> <br /> <br />UlbII'RAcroR SE.Gl'IOlN <br /> <br />COl!IPM'l /f2e; t.1D ,(Jo--z-~ ~. <br />State Cert. or Regist.' # Co z fi ,2 t{ <br />City License Registration I :lS-3. <br />****************************************** <br /> <br />Signature <br /> <br />0) J' <br />Si lPn::lture x I' ;//'"". <br /> <br />J. <br />, (I J I, _ ! <br />ClJIIP~ " I .. ':'In I. ,.., e, 'r. ( <br />/ 7' State Cert. or Regist. I; /) ) ! ' <br />J. ',P' /r'../ City License Registration # .?"S '1 <br />****************************************** <br /> <br />. / C " <br /> <br />_ -(7. M <br />c' ,(ar,:J i)'3 <br /> <br />u -.; ~, i <br /> <br />.,./ ./ <br /> <br />PLUlBER rh OOIIPOY )l2-rtl(/~ )" ~Ht.~A.v 1)~6'1 &~/.vc , <br />iff State Cc;rt. or Regist.1 . er~ <br />Signat:ure W1f~ City Licen.o;e Registration , II c,o(j:./7.;2/ <br />....~...................................... \ . .. ,,/7/- 7iPtT <br /> <br />KEalANICAL COIPARY <br />State ~rt. or Regist. ,,___ <br />Signature _ City P:.icense Registration t <br />***********~~*~*.************************ <br /> <br />S igoature <br /> <br />!:O!IPAIliY <br />St&t.€. Cert',. or Regist. t <br />City '~i~~e Registration , <br />***.*****..*..~****~*~~*~+~*************** <br /> <br />J!~~ ~4",r <br /> <br />. <br /> <br />0T1JF.R <br /> <br />APPLICATIOIiI APPROVED BY <br /> <br />PERKIT OFFICER. <br />