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<br />APPLn~A:l"IOlti1 FOR '?ERBIT <br />CI'If ,":,:t: 'Z:EP:\.1Yl~f( P",'?..3 <br />DmI.DI.BC DEPARntmn' <br /> <br />OWNER'S RAItE <br /> <br />/(:;: (5 f,'\.J <br /> <br />pf:J 'j. b <br />~ g ~!-I4 N -J I ,t,tS' /(fl\.- <br /> <br />PIIONE <br /> <br />V~(' <br /> <br />OWNER'S ADDRESS <br /> <br />!.. 6t <br /> <br />JOB ADDRESS <br /> <br />~ t..J l-~ ~ <br /> <br />LEGAL DESCRIPTION: LOI'(S) <br />PARCEL LD.' 3~ :2& - J-I <br /> <br />BI..OCK SUBDIVISION S '/ v -r '? <br />Q ~ /6 0 ~C')G 6 (J g f 0 <br /> <br />C.) k1 (L( S' <br /> <br />WORK PROPOSED:_IMew Construction ~tion _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />_"IF <br /> <br />_' of Units <br />~Swia. Pool <br /> <br />_K/H <br /> <br />_<=<-ercial <br /> <br />_Indust. <br /> <br />Other <br /> <br />_Rest:aurant &: Hea1th ~t Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL : <br />cottKERCIAL : <br /> <br />A'lTACH (2) PLOT PI.AIIS &: (2) SEIS OF BUILlH.NG PLUS &: (1) SET ENERGY FORKS. ** <br />ATI'ACH (3) SEI'S OF BUTI.DIIIG PLUS &: (1) SET ENERGY FORKS. ** <br />**COPY' OF COINTRACT KIlQ1BIRIlD. <br /> <br />PEmIITS REQUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />/ / I 600 <br />I <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />_._Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />~CAL <br /> <br />$ <br /> <br />Valuation of Kecbanical Inst:allation <br /> <br />_PLUMBING GAS KOOYlJiiG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _~ _Steel <br /> <br />Other <br /> <br />FIliISHED FLOOR ELEVATIOlNlS: <br /> <br />FI' . <br /> <br />IS PROJECT Df FLOOD ZOHE AREA? <br /> <br />YES NO <br /> <br />***********~**~************************.** <br /> <br />RmT.DER <br /> <br /> <br />CIlWI1IACIOO S~ON .- ((.- <br />CO!IPAm tLc;~ J G~ C~-J'.-c.-- <br />St:ate Cert. or Regist.' C C. <::Jl-!SS''-(.l- <br />City LicbdSe Registration I <br />**********************w******************* <br /> <br />Signature <br /> <br />~CIAN ~ COIIPAIIY ~f(1"'''- lV'znadJ <br />. <br />St:ate Cert. or Regist. 41 <br />S' a re 0.<' ^'" /'\./'vI':;;', City License Registration t <br />*********************************** <br /> <br />TM C', <br />~YJ <br /> <br />CO!IPOY <br />St:ate Cert. or Regist. I <br />City License Registration f <br />****************************************** <br /> <br />PLlItBER <br /> <br />Signature <br /> <br />aliliPAlNlY <br />St:ate Cert. or Regist. I <br />City License Registration t <br />**************************************~*** <br /> <br />CO!IPoy-Ifl ~k7 ~.0P7114-- <br /> <br />St:ate Cert. or Regist. ,/ /<xooJ~;)~1 <br />City ~icense Registration I <br />*************"r.***~*~~******************* <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br /> <br /> <br />~~ <br /> <br />~c"/~~""" l~;, <br /> <br />k*~OVED BY <br />':; \ ____ :3 <br />\"'~" ~ .~'b,2' <br />-:."... ~.............~~ ,,~~~ <br /> <br />~"""(' ~ 1itC) "..+.... <br />"'flun".""\" <br /> <br />/l,,~ ?<f~~ <br /> <br />PERKIT OFFICER. <br />