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<br />APPLICAT.!OIL FUR ftl.RtIIT <br />CITY OF ZlrJ!HIKH I . I.S <br />BUIIJURG DEPARIIIUI' <br /> <br />OIlIIEIl'S wdfJt.Jl1.R 'f~ . I~ ~:, f? I~Ji it>,>< <br />OWNER'S ADDRESS c;(!).() I Jt/~-nP..A <br />.JOB ADDRESS .s;:. A fr; {; <br /> <br />moRE <br /> <br />LEGAL DESCRIPI'IOl'l: UJI'(S) <br /> <br />BJ.OCl{ <br /> <br />SUBDIVISION <br /> <br />/7/II{ <br /> <br /><:'- <br />- ). <br /> <br />,. <br />Jp <br /> <br />PARCEL I. D. t <br /> <br />WRK PROPOSED:_Jle.v Construction ~tion _A1teration _Repair, _Install <br /> <br />_Sign <br /> <br />_lItove <br /> <br />_DeIIo1ish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />_tf./F <br /> <br />_, of Units <br /> <br />_K/H <br /> <br />_<=<-ercia1 <br /> <br />_I:odust. <br /> <br />_Swi..-. Poo1 <br /> <br />Ot:her <br /> <br />BUILDING SIZE: <br /> <br />_Rest:aurant &: Hea1t:h ~t Approva1 <br />~ X IS-, <br /> <br />~e Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />cottKERCIAL : <br /> <br />AlTAaI (2) PUJI' PIABS &: (2) SEI'S OF BUILDDfG PLAI8IS &: (1) SET ENERGY FORKS. ** <br />ATTACH (3) SEI'S OF BUD..DD'G PI.MS &: (1) SET ENERGY FORKS.** <br />**OOPY OF OONTRACT RIlQUIRIlD. <br /> <br />PERKTTS REOUESTED <br /> <br />------BUTI.DIlIG <br /> <br />$ <br /> <br />J'/).c:; c' <br /> <br />Va1uation of Tot:a1 Construction <br /> <br />F.J.F.CfRICAL <br /> <br />.AIfP Service <br /> <br />F10rida Power CO~. <br /> <br />W.R.E.C. <br /> <br />.-JtECIIAIilCAL <br /> <br />$ <br /> <br />Va1uation of Hecbanica1 Installation <br /> <br />_PLUKBIlIG <br /> <br />GAS <br /> <br />KOOFDIG <br /> <br />SPECIALTY <br /> <br />TYPE OF OONSTRUCTIOJl: _B1ock <br /> <br />,/ <br />~FraIIe _Stee1 <br /> <br />Ot:her <br /> <br />FIIIISIIED FLOOR ELEVATImiS: <br /> <br />FT. <br /> <br />IS PRO.JEc''T Dl FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />**..***..********************************* <br /> <br />cmrI'BACIOR SECI'ION <br /> <br />RIJTT JlF.R <br /> <br />(DIPAIIY <br />C7),A " O^ l" &- OIQ t;J State Cert. or Regist. I <br />I//A.A(O LO I.-L-Z Ub-1?t-A City License Regist:.rattOn , <br />****..*******************.**************** <br /> <br />(;J /7' 51 <br /> <br />Signature <br /> <br />F.J .F.cnuCIAN <br /> <br />CD!IPA1liY <br />State Cert. or Regist. " <br />City License Registration t <br />*****************A&&&&~A****************** <br /> <br />SilPllsture <br /> <br />(DIPMY' <br />State Cer!:. or Regist:. f <br />City License Registration t <br />**********.**************~~~~************* <br /> <br />PLlIIBER <br /> <br />Signature <br /> <br />CD!IPARY <br />State Cert. or Regist. I <br />City License Registration I <br />****.*********....************************** <br /> <br />KEaWiICAL <br /> <br />Signature <br /> <br />CD!IPMiY <br />State Cert:. or Regist:. f <br />City Lf.cense Registration I- <br />****************************************** <br /> <br />. <br /> <br />O'I'IIRR <br /> <br />S igoature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />