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<br />\ \)\ \ <br />t,'" <br />II' ,.:'. <br />\' ...-t <br /> <br />APPLICATIOIi FOR PERKl.T <br />GIn aF :z.:EPRYRKILLS <br />BIITLDTIiG DEPARli1Ul:liW~' <br /> <br />OWNER'S ADDRESS <br /> <br />r <br /> <br />.i/~i / -l/ <br />/" ..-. .. <br />L it It...' ,1._ ":'-1:';". J /Iv /--,/ /'. <br />;;;;.:._ r / ,I ~.. / / . L-:/ <br />.JOB ADDRESS .J /1': -; r;]) l. IF.' yL./ " / /: f- - C t..d)! /t~ 1', / I.~ r "/ I.] <br /> <br />LEGAL DESCRIPl'Imi: L.OT(S) Ii :(:-; ~stmDIVISIOINII{~. i,.' I....'.", ,-I /!J1J:/I~'''''' <br /> <br />~; <br />'~',-'- , " 1 <br />...~ /;'- '-'-' I . ../ <br />-, <br /> <br />'~ <br /> <br />"{'f; C <br /> <br />, OWNER'S RAKE <br /> <br />PHOH <br /> <br />. /i. <br /> <br />::-.) <br />..l<; <br /> <br />.. (~ <br /> <br />, / <br /> <br />PARCEL I. D. t <br /> <br />/ / ,! ._ ('-, 1; - '/_ <br />/ wi . f:-/ /'_ <br /> <br />(///-.( } ~--(>:~/~J '/-j -- <br /> <br />( ), >,'.'" <br />, 't, I' <br /> <br />WORK PROPOSED:--L::.lIev Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: ~Sing1e Faaily <br /> <br />_"'F <br /> <br />_' of Units <br /> <br />_K/H <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_SwUi. Pool <br /> <br />Other <br /> <br />BUILDING SIZE: <br /> <br />Res1:.aUrant &: Health Departaent Approval <br />---- 1 <br />_.~{. (~ /~,-/ I{ I; / J(~ ~ ' <br />X . '. I .._' (, -'I} ;:/. ~e Feet. <br /> <br />Height <br /> <br />RESIDENTIAL : <br />cottMERCIAL : <br /> <br />AlTACH (2) PL.OI' PLANlS &: (2) SEtS OF BUILDING PLUS &: (1) SE1' ENERGY FORMS. ** <br />ATI'AaI (3) SETS OF BmLDIINIG l'LU'S &: (1) SET ENERGY FORKS. ** <br />**COPY OF COINITRACT REQ1ffRED. <br /> <br />PEHI!IITS REQUESTED <br /> <br />~~UILDING <br /> <br />,_" ~ ).1 <br />$ ';- i1 ) (,,' I,,,' <' :..-:--~ <br /> <br />Valuation of Tot:al. Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />,~ <br />t....... W.R.E.C. <br /> <br />_KECllANICAL <br /> <br />$ <br /> <br />I <br />Valuation of Kechanical Installation <br /> <br />_PLUKBIBG GAS ROOFDiG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTlUJCTION: _Block. _Fraae _Steel <br /> <br />O.-.her <br /> <br />FIliISBED FLOOR ELEVATIONS: <br /> <br />Ff' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />**.*****:**..**.**...***.*.*.**..*.***..** <br /> <br />~ I <br />if ( <br />r'" '~~ I j. <br /> <br />/ ./ <br />CO!IPANY l ,~-I (:. t " ..':,; .. (. )",,; \ ,J <br />/. I ._ . <br />! State Cert. or Regist. # ".... ;. - C I. '. ,.' <br />L/u ';"~,6 "....-;~, City License Registration I f.'~.It:~ ::' (. :: <br />, <br />...*.**~****.*...*.....*.*.....*****.***.* <br /> <br />CO?ITRACIOR SECTION <br /> <br />BUTT J)Y.R <br /> <br />/1 <br /> <br />Signature <br /> <br />,;,,-./7 ~/ <br /> <br />'~--~ /?/" (~ <br /> <br />SiPllature <br /> <br />CO!IPOY <br />State Cert. or Regist. ,1= <br />City License Registration t <br />.......***........***.....*..*..*.****.*** <br /> <br />ELECTRICIAN <br /> <br />CO!IPANY <br />State Cert. or Regist. I <br />City License Registration t <br />*.**...***...............*...**.********.. <br /> <br />PLUflBER <br /> <br />Signature <br /> <br />CO!IPMff <br />State Cert. or Regist. f <br />City License Registration I <br />**.*.*.~~*...***.*.....*.*.*....******...* <br /> <br />KEalANICAL <br /> <br />Signature _ <br /> <br />OTIIER. <br /> <br />CO!IPANY <br />State Cert. or Regist. t <br />City License Registration , <br />.....*.***...***..*..***...*.*...*.*****.* <br /> <br />. <br /> <br />Signatu.ce __' <br /> <br />APPLICATION APPROVED BY <br /> <br />VI d./l/\ .l'-A- Xi PAA~ <br /><t <br /> <br />PERKIT OF'!'T CSR. <br />