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<br />APPLICATION FOR PERKlT <br />GI'IY OF ZEPUYRHIi.LS <br />BUlLDDlG DEPAR1lItI!'Bf <br /> <br />OWNER · S RAttE <br /> <br />'- ~()'" "'\ <br /> <br />~'; \ \') '0 <br /> <br />PHONE <br /> <br />1~~\~ 4 \ \ t ~ <br /> <br />OWNER'S ADDRESS ~C\lY'~l\ ~ ~ M\lQNlW t-OtJ\\i.i\'h:\\';:) 't\ <br />\ <br />JOB ADDRESS ,'~() IIQ (\ Ci lh ~\lQ rid.Q ('. C~h\,\\~\ \ \:-, \- \ <br />(). \ (\ j~ ' <br />LEGAL DESCRIPTION: LOT(S) \'\arnriL ~) \l(;:.. B.I.OCK SUBDIVISION u) ~l \0 o\- II \- ')\.3:> <br />I N 'J.b ,40 \ D''r v:. ~l. \ 0' oS- <br />PARCEL LD.' \'1.9.\ n A." -()( ~ r;~D . (;CYl C'i) - ('l?J \(j, \G\-:;-.\ a\ \ ,>l. b\{\cv '1 " <br />z." V, \-.\r,\y~ ,~(\O.I "c~ <br />WRK PROPOSED:_l'Ilew Const:ruct:ion _Addit:"Lon _Alt:erat:ion _Repair +Inst:all <br /> <br />-,Sign <br /> <br />--1!fove <br /> <br />_Deao1ish <br /> <br />PROPOSED USE: <br /> <br />Single Faai1y <br /> <br />_"IF <br /> <br />_, of llfnit:s <br /> <br />_K/H <br /> <br />_~rcia1 <br /> <br />_Indust:. <br /> <br />_Swia. Pool <br /> <br />Other <br /> <br />Rest:aurant: &: Hea1th Depart:aent: Approva1 <br /> <br />BUILDING SIZE: __X <br /> <br />Square Feet:. <br /> <br />Height: <br /> <br />_ RESIDENTIAL: <br />cottItKRCIAL : <br /> <br />ATTACH (2) PL.OI' PI..OS &: (2) SEIS OF BUILDING PLAIIiIS &: (1) SET ENERGY FORMS. U <br />ATTACH (3) SEIS OF BUII.DDiG PLUlS &: (1) SEt' ENERGY FORMS. "'* <br />o4oo4oCO Ill" OF COIlilTRACT KIlQIlllUlD. <br /> <br />PERKITS REQUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Va1uat:ion of Tot:a1 Const:ruct:ion <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />F10rida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_KECHAlUCAL <br /> <br />s <br /> <br />Va1uat:ion of Kechanica1 IDst:allat:ion <br /> <br />_PLUKBIliG <br /> <br />GAS <br /> <br />:ROOFll~G <br /> <br />x <br />. <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTR1JC'l"lON: _B1ock ~ _St:ee1 <br /> <br />Other <br /> <br />FIRISBED FLOOR ELIVATIONS: <br /> <br />FI' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />COIil'I'RACIOR SECTION <br /> <br />\ S ignat:ure <br />:s <br />(; <br />Ii" <br /> <br />\ '. ;',' <br />.~ . \\ \.." ,'Y'" <br /> <br />WltPMIY N\ ~ (\ ,~) \ l \ ;.\ ('~r\ <br />St:at:e Cert:. or Regist:. , <br />City License Regist:rat:ion , <br />****************************************** <br /> <br />"~\( i~ (' \. <br /> <br />([-\ l :',C. <br /> <br />BUTIJ)ER <br /> <br />(\\(\~\~ (~C <br /> <br />'L\ c.: <br />. <br /> <br />ELECTRICIAH CUllPARY <br />St:at:e Cert:. or Regist:. , <br />Si2nat:ure City License Regist:rat:ion t <br />*************************************.**** <br /> <br />PLOKBER CUllPANY <br />St:at:e Cert:. or Regist:. , <br />Signature City License Regist:rat:ion I <br />*****.........***'**...****...***of,~....*t**...************ <br /> <br />KECHMUCAL CO!IPMY <br />Stat:e Cert:. or Regist:. I <br />Signature City License Regist:rat:ion I <br />****...*......******.....**...*...*.......***.......***.****** <br /> <br />0"I'1IF.R CUllPARY_ <br />S~at:e Cert:. or Regist:. , <br />Signature City License Regist:rat:ion , <br />.....***......***..............**.........*.*......*...................******* <br /> <br />APPLICATION APPROnm BY PERKIT OFFICER. <br />