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<br />APPLICATIOIII FOR PERKlT <br />CTIY OF 2Il:PHIKH II.T.,!i <br />Bl'TII.DTIiG DRPARnIE!iT <br /> <br />. / <br /> <br />;;YfSTt1 <br /> <br />f~~~ <br />ol f/rF 6?3 <br /> <br />'. <br /> <br />.... \;" P (<1 ( -r v () J to Sf /9 &.b-E:. <br />I <br />OWIIER'S ADDRESS ,1/ 7-#:{;' 'A.l, /S'3A s /- 7? "'tP/ <br />cfI' /.5 J.It- A: ve , 2=rJ '( r f-J/ / is <br />LEGAL DESCRIPTIOlI: UJI'(S) <br /> <br />mmm <br /> <br />tf' ( :J ~ f' 77 -c.l.. b tl.':l <br /> <br />OWIIER'S RAKE <br /> <br />t:"J _ <br />. r <br /> <br />JOB ADDRESS <br /> <br />~SUBDIVISIOR <br /> <br />PARCEL I. D. t <br /> <br />WRK PROPOSED:_5ev Construction ~tion _Alteration _Repair. -X:-Install <br /> <br />S' <br />- 19I1 <br /> <br />_!!love <br /> <br />_Deao1ish <br /> <br />PROPOSED USE: <br /> <br />Sing1e Faai1y <br /> <br />_ff/F <br /> <br />_' o:f Units <br /> <br />_K/H <br /> <br />_~rcia1 <br /> <br />._Indust. <br /> <br />_Swill. Poo1 <br /> <br />Other <br /> <br />_Rest:aurant 5: Bea1t:h Departaent Approval <br /> <br />BUILDIIIG SIZE: <br /> <br />x <br /> <br />~e Feet, <br /> <br />Height: <br /> <br />RESIDENTIAL: <br />cottKERCIAL : <br /> <br />A1TACII (2) PLOI' PLAlIS 5: (2) SEIS OF BUILDDiG PLUS 5: (1) SET ENERGY FORKS. ** <br />A1TACII (3) SETS OF BUILDDG PLUS &: CO SET ENERGY FORKS. ** <br />**COPr OF CONTRAcr RlJQUIRIlD. <br /> <br />PI!'RlPIT1"S REOOESTED <br /> <br />_BUILDIIIG <br /> <br />$ <br /> <br />Va1.uation o:f Tot:al. Construction <br /> <br />_ELECTRICAL <br /> <br />AtIP Service <br /> <br />F10rida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-,---1fECIIAIIICAL <br /> <br />$ <br /> <br />Yaluation o:f ffechanica1 Installation <br /> <br />_PLUKBIRG <br /> <br />x CAS <br /> <br />ROOFDiG <br /> <br />SPECIALTY <br /> <br />TYPE OF COIISTRUCTION: .K-B1ock _F1raIile _Stee1 <br /> <br />Other <br /> <br />FllIISHED FLOOR ELEVATIOBS: <br /> <br />FI' . <br /> <br />IS PRO.JEcr llf FLOOD ZOBE AREA? <br /> <br />YES NO <br /> <br />***************************************~** <br /> <br />COIIItI'RACI'OR SECTION <br /> <br />BmT.DF.R <br /> <br />Signature <br /> <br />COIIPANY <br />St:ate Cert. or Regist:. I <br />City License Registration , <br />*****.**.....******************************** <br /> <br />RTJI'..crRICIAIf <br /> <br />SiPll::llture <br /> <br />amPM.I' <br />St:ate Cert:. or Regist. , <br />City License Registration t <br />****************************************** <br /> <br />PLUlBER <br /> <br />Signature <br /> <br />COIIPARY <br />State Cert:. or Regist:. , <br />City License Registrati~ I <br />**********...**~*****v**~********~*~**** <br /> <br />KEalARICAI. <br /> <br />Signature <br /> <br />aJIIPANY <br />St:ate Cert:. or Regist:." <br />City License Registration I <br />****************************************** <br /> <br />0T1IF.R COIIPAln' ~ n 'itI h~ <br />~fl St:ate Cert. or ist:.- t <br />Si1!naU ____~ eUy License Registnotico . <br />( * * ***~*aAAAAA********************* <br /> <br />c.... <br />'~7D9 <br />3{i'/ ' <br /> <br />APPLICATIOII APPROVI!'D BY <br /> <br />PERMIT OFFICER. <br />