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<br />APPLICA"o."ION Fo(.,h~ PEl'il!fiT <br />CITY OF ZE:1IYRiI.ILLS <br />BUTILDlliG DEPAR1'KENT <br /> <br />OWNER · S <br /> <br />=RFS:;~;; It;; ~7J$..v~~ <br />J <br /> <br />PHONE <br /> <br />OWNER · S <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(5) <br />PARCEL LD.' 31 -d..S--~ I ...s - ~ <br /> <br />BLOCK <br /> <br />SUlBDIVISION <br /> <br />IroRK PROPOSED: ~ev Construction _Addition _Alteration _Re93ir _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deao1ish <br /> <br />PROPOSED USE: Sing1e F~i1y <br />Veo-ercia1 <br /> <br />_KIF <br /> <br />_, of Units <br /> <br />_HID <br /> <br />_Indust. <br /> <br />_Swia. Poo1 <br /> <br />Other <br /> <br />_Rest:aurant &: Hea1t:h Depart:aent Approva1 <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL : <br />COHKERCIAL : <br /> <br />ATTACH (2) PLot PLAliS &: (2) SEIS OF BlITLDIXG PI..lWS &: (1) SET RNERGY FORMS. ** <br />ATTACH (3) SEIS OF BlJIIJ)ING PLAliS &: (1) SET El!mR.GY FORHS.** <br />**COPV OF CONTRACT RIl'Qm:RED. <br /> <br />/ <br />_BUILDING <br />V ELECTRICAL <br />/KECHAIf[CAL <br />~UHBIlIG <br /> <br />PERl!IITS REQUESTED <br /> <br />$ <br /> <br />Va1uatiou of Tot:a1 Construction <br /> <br />AKP Service <br /> <br />F10rida Power Corp. <br /> <br />W.R.E.C. <br /> <br />s <br /> <br />Va1uatiou of Hecbanical Installation <br /> <br />GAS <br /> <br />IIDOFING <br />. <br /> <br />SPECIALTI' <br /> <br />TYPE OF CONSTRUCTION: _B1ock <br /> <br />_FrMle _Stee1 <br /> <br />Other <br /> <br />FHiISBED FLOOR ELEVATIONS: <br /> <br />FI' . <br /> <br />IS PRO..JECT IN FLOOD ZONE AREA? <br /> <br /> <br />YES NO <br /> <br />************************************* <br /> <br />COIIJ'I'RACI'OR S~ON <br /> <br />MY ~ <br />St:ate Cert:. or Regist:. , <br />City License Registration <br />****************************************** <br /> <br /> <br />COlIPA1MY <br />St:ate Cert. or Regist. , <br />City License Registration t <br />****************************************** <br /> <br />PLDlBER <br /> <br />Signature <br /> <br />COlIPABY <br />St:ate Cert:. or Regist:. ## <br />~~L> Lic~e R~gi~~ra~ion t <br />**********t*********~~******************** <br /> <br />KECllANICAL <br /> <br />Signature <br /> <br />a>>tPABY <br />St:ate Cert. or Regist. I <br />City License Registration I <br />****************************************** <br /> <br />OTHER <br /> <br />Signature <br /> <br />CO!tPAIin' <br />State ~rt. or Regist. ## <br />City License Registration I <br />*********************~~******************* <br /> <br />. <br /> <br />APPLICATION APPROVED BY <br /> <br />PRRKIT OFFICER. <br />