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<br />APPLICI\TI05 FOR jJ:RK[T <br />CI'IY OF ZEPi "fl~:LT ~ <br />BlIUJllliG DEPARI1!DJ1iJ1' <br /> <br />;SOANNl /(111 tlj),'rF <br />OWNER'S ADDRESS to, ({OX bC~ )..Gl!Sbur~ <br />.JOB ADDRESS eOr)/~ 11 S-T~ 6" r ...LlNe/ /1_ AVE, <br />LEGAL DESCRIPTION: 1DI'(S) WIt cr wf /01 R!.OCK /0 SUBDIVISI05 <br />PARCEL LD.' /9- 02 b - d- / <br /> <br />PIlOn 9';'- - 7.si - ~ r;r:-." <br />S'/7?r- <br /> <br />OWNER'S RAKE <br /> <br />GA. <br /> <br />11(1(J~E'S ,c; '~r ./f'.///r; i7/V <br /> <br />WORK PROPOSED: ~5ew Construction _ ...JWdj.tion _Alteration <br /> <br />_Repair <br /> <br />_Install <br /> <br />_Sign <br /> <br />_!!love <br /> <br />_DeaoHsh <br /> <br />PROPOSED USE: <br /> <br />Single Fallily <br /> <br />IK/F <br /> <br />~, of Units <br /> <br />_K/H <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_Swi..-. Pool <br /> <br />Other <br /> <br />_Restaurant &- Hea I. t:h nepan:.ent Approval <br /> <br />, I <br />BUILDING SIZE: ~6 X J./c:> . <br /> <br />jol/d <br /> <br />Square Feet. <br /> <br />8" <br /> <br />Height <br /> <br />RESIDENTIAL: <br />cottKERCIAL : <br /> <br />AnACII (2) PLOI' l'I.ANi &- (2) SEI'S OF BUILDIRG PLANS &- (1) SEt' ENERGY FORKS. ** <br />AlTACII (3) SEI'S OF E,!JILDDlG PLO'S &- (1) SEI' ENERGY FORKS.*'" <br />**COPT OF COINTRACT R SQlJTIRED. <br /> <br />PERl!lITS REQUESTED <br /> <br />~BUILDING <br /> <br />/ELECTRICAL <br /> <br />~ttECllABICAL <br /> <br />~PL1JKBIHG <br /> <br />$ <br /> <br />Valuation o:f Tot:a1 Construction <br /> <br />MIP Service <br /> <br />.Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />,Valuation ..,f Kecbanical Installation <br /> <br />GAS <br /> <br />TYPE OF CONSTRUCTION: ~IOCk <br />{].11, , '/ <br />FTIlISHED FLOOR ELEVATIORS: G'#-g F1. <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />_Fraae <br /> <br />_~(r-eel <br /> <br />Other <br /> <br />IS PROJECT Il!i FLOOD ZONE AREA? <br /> <br />/ <br /> <br />YES NO <br /> <br />........*"'.....**"'- :l:*...**..il-Ir......,::'I:.*............"'*.."'.*** <br /> <br />C'.)Wl'RACI'OR SEC1"ION <br /> <br />Signature <br /> <br />/ W!lPMJY /j. rO ,eO/lo r <br />/J~ 7'..// A/~ State 'Cert:. or Regist:. , 00(007 <br />I5cA ~ City License Registration , 0 <br />..............~*.***..............k*...........................*~'" <br /> <br />=CIAH ~ L W!IP.DY h~.! s. -c. ('/A.-S ~? <br />-~/-. ., cA I St:a.te Cert:. or Regist. , F/<-. 0 C' / /.s-) 7 <br />~ _re v. ~ '_ City License Registration f /59 <br />~ . .....***.*.~"'....**..**.**~*.**.......*....*.*......** ' <br /> <br />~ I r W!lPARY Jf/)..ro/( ~o/t/6r: <br />~ r..-// h~ S~te ~rt. or R-:gist. .' p' O'oJ"7ouQ <br />_ _ ~~ C1.t:y L1cense Reg1strat1OD. , ;)3' <br />***"'*.**~"'*~.*.......**~***~********."'**** <br />-=::::- \ (f <br />~;; C'.~ ;t/ /-- V <br /> <br />BmTJ)ER <br /> <br />PLDmER <br /> <br />. Signature <br /> <br />Signature <br /> <br />?i <br /> <br /> <br />c.nJIIPADY <br />State Cert. or Regist. , <br />City License Registration I <br />..........~*.***'"',. ~*..***"'.."'*~*** <br /> <br />KECllANICAL <br /> <br />do- <br /> <br />Signature <br /> <br />amtPANY <br />State Cert. or Regist:. 1;_____ <br />_,_u__ City I.icense Registration if <br />****'" :A-**,', ***.~,.~"~-A';a, :Ht*******..*..*~.*"'*...."'.'" <br /> <br />. <br /> <br />OTRF.R <br /> <br />APPLICAnOIi APPROVED <br /> <br />BY L~-~~L>~"- <br /> <br />PERKIT OFFICER. <br />