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<br />APPLICATION FOR PERKIT <br />CIY'.l OF ZEPIIYlllXII.I..S <br />BtJrUDlliG DEPAR'DIIlXT <br /> <br />OWNER · S <br /> <br />MAKE ~jZ'fZ-~N\ ~~ <br /> <br />vJ~f <br /> <br />PRONE . <br /> <br />.?~1:~ <br /> <br />OWNER' S ADDRESS <br /> <br />JOB ADDRESS 31 8l ? <br /> <br />I ? ,t1 G. 1'. W. <br /> <br />LEGAL DESCRIPTION: I.OI'(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D.I <br />WRJ{ PROPOSED:_5ew Construction .--.J\ddi.tioo. 1A1teration. _Repair _Install <br /> <br />_Sign <br /> <br />_I!tove <br /> <br />_ne.o1ish <br /> <br />PROPOSED USE: <br /> <br />Single Faai1y <br /> <br />-LK/F <br /> <br />_Indust. <br /> <br />_, of Units <br />_S~. P001, ~ GLf- <br /> <br />_"/H <br /> <br />_~rcia1 <br /> <br />Ot:her <br /> <br />_Restaurant &: Hea1t:h Depart:.ent Approva1 <br /> <br />BUILDUiG SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL : <br />cottKERCIAL : <br /> <br />A'l'TACII (2) PLOI' PI..MlS &: (2) SEI'S OF BUllDIMG PLUlS .&: (1) SEI' EllERGY FORMS. ** <br />ATTACH (3) SETS OF BUII.DDIIG PLUlS &: (1) SEI' ENERGY FORMS. ** <br />**COPt' OF CONTRACT REQunmD. <br /> <br />PERl!lITS REQUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Va1uatioo. of Tot:a1 Construction <br /> <br />_ELECTRICAL <br />-X....KECllAllICAL <br /> <br />.AKP Service <br /> <br />F10rida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ 31\'157.00 <br /> <br />Va1uation of lIIechanica1 Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION!: _B1ock. _Fraae _Stee1 <br /> <br />Ot:.her <br /> <br />FIlfiSHED FLOOR ELEVATI05S: <br /> <br />Fr. <br /> <br />IS PRO.JECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />********~********************************* <br /> <br />CON'I'RACIOR SECITON <br /> <br />COI!IPMUY <br />State Cert. or Regist. I <br />City License Registration I <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />SiPTlature <br /> <br />COI!IPARY <br />State Cert. or Regist. I <br />_ City License Registration 1 <br />******t*t*****......******************t***t**'* <br /> <br />ELECTRICIAN <br /> <br />Signature <br /> <br /> <br />COI!IPMiY <br />State Cert. or Regist. t <br />City License Registration 1 <br />**********t*****......*************ttt**t**t** <br /> <br />PI.OttBER <br /> <br />Signature <br /> <br />KECllAllICAL <br /> <br />COI!IPANY ?faMN--\ ~\ft.'7 ~1~\l.L.G~~ J INC.. <br />State Cert. or Regist. 1 oo't-'\~BooO\"16 <br />City License Registration 1 ('.?1/ ~ <br />**************......************************** ..- <br /> <br />COI!IPAlWY <br />State Cert. or Regist. I <br />City License Registration , <br />********t*************************t**t**** <br /> <br />. <br /> <br />0'I'1IF.R <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />}fd.4<.f'~ >B~h-.'- <br /> <br />PERKIT OFFICER. <br />