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<br />APPLICA'l'IOlSl FOR PERKIT <br />CITY OF 2.EPUIKHII.I.~ <br />BUIIJnlllG DEPARI'I!IHIiIT <br /> <br />OWNER' S IiAtnj<. '\ 0- _ l;.,\J \<-7" wE.., ~ ~ PIlOn 'l ~ ~ .- to ~ '\ ~ <br />GE. V \\ 'j ,~\-\ \"" '\. S ~ 'L- <br /> <br />OWNER' S ADDRESS5 q~. ~ . ~..,. \\ ':s.. '\ <br /> <br />. .f /' <br /> <br />JOB ADDRESS 0 j S ',:S /~ll--<:- L. (~l(l /Ij~ L <br />LEGAL DESCRIPTI01If: wr(S) \ 0 ~ ~SUBDIVISIOIi1 "&'h..Di::.-~:. <br />PARCEL LD.,O ~- t;l\g - ~\ - 0 \ -at) - C (}~f') - ~ C)~ Q) <br /> <br />t)~'C.~ <br /> <br />... ~:" <br />.;:;;. V.i~:... <br /> <br />WRK PROPOSED: ?< JJrev Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_!!love <br /> <br />_ne.olish <br /> <br />PROPOSED USE: -f.-.. Single Faaily <br /> <br />_KIF <br /> <br />.L, of Units <br /> <br />_K/H <br /> <br />_~rcia1 <br /> <br />_Indust. <br /> <br />_SwUi. Pool <br /> <br />Other <br /> <br />_Rest:aurant &: Hea1t:h ~t Approva1 <br />BUILDING SIZE:9t '~ \\ X S~. \ '\ oS Square Feet. <br /> <br />l <br />\~ <br /> <br />\ S;-ro~ Height <br /> <br />RESIDENTIAL: A'l'TACII (2) PLOT PLAliS &: (2) SEI'S OF BUILDING PLUS &: (1) SEI' ENERGY FORKS. ** <br />COKftERCIAL: ATI'ACO: (3) SEI'S OF BUILDDIG PLOlS &: (1) SEI' mmRGY FORKS. ** <br />u'COPT OF COftRACT BIlQlITRIlD. <br /> <br />PEBI!IITS REOUESTED <br /> <br />~ BUILDING <br />-"""ELECTRICAL <br />'f..-.. KEGIIAIfi CAL <br />,.L:.PUJKBING <br /> <br />$ ~S~tb'<b <br />\ '56 <br />$ ';} ~\ ~l.!> <br /> <br />Va1uation of Total Construction <br />At.f.P Service ''f.-.. Florida Power Corp. <br /> <br />._W.R.E.C. <br /> <br />Va1uation c..~ Mechanical Installation <br /> <br />GAS <br />"""" Block <br /> <br />ROOFlliG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUt::T .inN: <br /> <br />_. _FLase <br /> <br />_St:eel <br /> <br />Other <br /> <br />YES <br /> <br />~ <br />NO <br /> <br />PTIfiSHED FLOOR ELEVATIOBS: <br /> <br />FI' . <br /> <br />IS PROJECT Df FLOOD ZONE AREA'? <br /> <br />..................~.......~.........*..** <br /> <br />CDIIITKACIOR SECTION <br /> <br />BmT.DER ~ CD!IPOY <br />\- St:ate Cert. or Regist. I C~~O 'l~~ t::>.~ <br />Signature ~QJ City License Registration I ....5'17 <br />.......................................... <br /> <br />ELECTRICIAN <br />sismatur~\\./~~ <br /> <br />CD!IPABY FEE t:. Lt~~~\C- <br />r St:ate Cert. or Regist. I S Q} d> 41.&> 4. ~ <br />L_l ~ --' City License Registration f .C;O <br />........~..~....................*........ <br /> <br />P~ CD!IPARY~"'~~~C-'== ~ ,)illc."".. <br />) St:ate Cert. or Regist. I <br />S' ture ~ City License RegistratiOn I \ ~ ~ <br />.s ~. - l~..~~~............**............*..*.. <br /> <br />K.EaIAIU~' ~ CD!IP~~~ u.:> \:) q: 'S:. ~ " ~) f,-~ <br />\ . (l ---l.1\ St:ate Cert. or Regist. I <br />Signature 'V )( .}A!\!) City License Registration I / () 7 <br />...**...~....**......................*... <br /> <br />CD!IPMiY <br />St:at:e Cert. or Regist. t <br />City License Registration I <br />.**....*~~..~.........*.................. <br /> <br />)1~>fY.fM0; <br /> <br />. <br /> <br />01'1IRR <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />