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<br />APPLICATION FOR PERKIT <br />CITY OF ZEmYRBILLS <br />BUTI.DDiG DEPARlKElIilT <br /> <br />.OWHER'S lWtE Q1LC K#5.YS <br />OWHER'S ADDRESS .:l*itJ STlti ~ ~. ~1 <br />JOB ADDRRSSL.()-r:d,b 38~/')' ~1Jf()hPIJA J.tx;p <br /> <br />t"I/ J-HJ M 6. 5' A i..u S' <br />, <br /> <br />ZE.fJlI '1',e IfiLL $ <br />W!J y W/l~/J W/AI.ttS <br /> <br />PIIONE <br /> <br />7ftJ' -7f'9o <br />r//J. J-sS'/1 <br />PI //1' jJ./J-;I<K <br />/ <br /> <br />LEGAL DESCRIPTION: 1..01'(5) <br /> <br />BT...oc:K <br /> <br />SlllBDIVISION <br /> <br />PARCEL 1. D. f <br /> <br />J 1. - :21:? ~ .:2 I - 0/ btJ .. CJ/)t/pp... tJ tJ./..o <br /> <br />RORK PROPOSED: v'Xew Construction _Addition _Alteration <br /> <br />_Repair <br /> <br />_Install <br /> <br />_Sign <br /> <br />_Kove <br /> <br />_DeJIOHsh <br /> <br />// <br />PROPOSED USE: v Single Faaily <br /> <br />_"-IF <br /> <br />_* of Units <br /> <br />_H/H <br /> <br />_COIIIIIercia1 <br /> <br />_Indust. <br /> <br />_SwI... Pool <br /> <br />Ot:her <br /> <br />_Restaurant &: Healt:h Depart:lM!nt Approval <br /> <br />BUILDING SIZE: /.2.. X ? <br />, <br /> <br />'7btf PA/()ER.KotJ~ Square Feet. <br /> <br />P:7t!) 9' <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COKKERCIAL : <br /> <br />A'ITACII (2) PLOI' PI.MilS &: (2) SEIS OF BlITLDIMG PU\MS &: (1) SET RHERGY FORKS. ** <br />A'ITACH (3) SETS OF BUTI.DDG PU\MS &: (1) SET ErrmRGY FORMS. U' <br />*-4-COPY OF COIlITRACT Rlr.Qm:RED. <br /> <br />PEmlITS REOUESTED <br /> <br />("BUILDING <br /> <br />$ <br /> <br />hJ J.7 ,.00 <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 />_HECHANICAI. <br /> <br />s <br /> <br />Valuation of Mechanical Ins'tallation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block ,...., Pralle _Steel <br /> <br />/1 J,/A p"/ - <br /> <br />Other <br /> <br />FINISHED FLOOR EI.EVATIONS: <br /> <br />FI' . <br /> <br />IS PROJECT IN FLOOD ZONE .AREA? <br /> <br />YES NO <br /> <br />-4-***-4-*-4-******************-4-*-4-****-4-*-4--4-**-4--4-t-4- <br /> <br />BUIIDER <br /> <br />COllD'RACTOR SECT'ION <br /> <br />COfPMY /lcE/lL U/J? ' <br />/) #/ ...J- /J . State CerL or RegisL .C/2C t::) Jy'~t) <br />~ City License Registration :J / 60 <br />**************************-4--4-***-4--4--4-*-4-*-4--4-*** <br /> <br />Signature <br /> <br />Sismature <br /> <br />COItPANY <br />State Cert. or Regist., :J <br />City License Registratjon I <br />********************************-4--4-*-4-**-4-*-4-* <br /> <br />ELECl'RICIAN <br /> <br />COMPANY <br />State Cert. or Regist. :J <br />City License Registration I <br />*************************-4-****-4-*-4--4-*-4-***-4--4--4- <br /> <br />PLOKBER <br /> <br />Signature <br /> <br />CO'IIPANY <br />State Cert. or Regist. :J <br />City License Registration I <br />*************************-4-******-I:-I:-I:*-I:***-4--:!: <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />7l,l4A~-J <br /> <br />COMPANY <br />State Cert. or Regist. :J <br />City License Registration M <br />***********.**~.**********~****-I:**-4--I:**~*-:!:-I: <br />r~~~ <br />~J"/l ..dl-t}-I <br /> <br />L"-_...- <br /> <br />0T1IER <br /> <br />Signature <br /> <br />APPLICAUON APPROVED BY <br /> <br />.> '"'1 <br />PERKIT OFFICER. <br /> <br />",:,,;,..,"""":"- <br /> <br />~ <br />