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<br />APPI.ICATI01N1 FOR I"EmITT <br />C][TY OF ZEPiIYRHIU,S <br />RUILDI~G DEPARTMENT <br /> <br />Oh.'NER' S NAME fYJ I? -+ h1~"5 GC1dJLt ~ P AJ IV eR.. <br />OWNER'S ADDRESS (; (C{v1 (~ If It ~ D <br />JOB ADDRESS ::5 H f11 ~ <br /> <br />PHONE ? X ~ - S{~<6. <br /> <br />LEG.I\L DESCRIPTION: 10'']['(5) <br /> <br />BLOCK <br /> <br />R"'-..,LJ //-. C [J <br />SUBDH"ISION <.....:./ " ~ . - J ,..- C'::... <br /> <br />PARCEL I. D.' <br /> <br />WORK PROPOSED:_!!iJe'lK' C'.onstruc:t 'On -X-Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_DeJlI()lish <br /> <br />PROPOSED USE: <br /> <br />Single FaIlIily <br /> <br />_tIfF <br /> <br />_:/iF of Units <br /> <br />_K/H <br /> <br />_ComImercial <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />Other <br /> <br />_Restaurant & l,:",alth Depart:JBlent: Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />,_.._~ <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COHHERCIAL : <br /> <br />AT'fACII (2) purr p! ,UliS & (2) SEJrS OF BlJlILDUJG pLMllS & (1) SIT ENERGY FORMS. H <br />AT'fACH (3) SETS n. BillUnOOG P:I....MiJS & (1) SET ElME:RGY FORMS.->\--;! <br />,uCOpy OF CONTRAC RlE'QmJlUlD. <br /> <br />PElIml'Y'S REQUJESTED <br /> <br />k' <br />~BUILDING <br /> <br />$ <br /> <br />'70-0 <br /> <br />Valuat:ion of Total Const.rnction <br /> <br />_ELECTRICAL <br /> <br />mp Service <br /> <br />Florida POWCll- (".orp. <br /> <br />W.R.E.C. <br /> <br />_MECHANICAL <br /> <br />:$ <br /> <br />Valuation of Hechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFDiG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Bloc J <br /> <br />_FraJlle _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATImifS: <br /> <br />}r'T. <br /> <br />IS PRo.JECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />~~~-;\-~~~***~****************************** <br /> <br />COINJTRACJ'OR SE,CTIONl <br /> <br />OOIMPMlfY /)/, / (e {.eJ I'/Ir ,/1 /?,(' 5 <br />State Cert:. or Regist. #I <br />City License Registration #' <br /> <br />/?, 7' - <br />L_ 0 r <-/..5//:':' (.)cl (' <"?-{ <br /> <br />BUILDER <br /> <br />.~ <br />/?t- <br /> <br />v <br /> <br />[c)d~~.~ <br /> <br />Signature <br /> <br />~~~~~~ ~~.*~~~~*~~~~*~*~*~~~t~~~~~~~~~~~~~ <br /> <br />ELECTRICIAN <Cn'!iP'AL."lIY <br />State Cert. or Regist. *' <br />Si~ature City License Registration #F <br /> <br />1J;:-fl:~-!:fJ:-!; ~*.ii::'9::i!:iJ;:'i::''f1r-e.*11::1l;1l::-9::-R:~*1k~~~il:~iJ::1k**~'!1-:'~~'%:"*-:~ <br /> <br />PLUlKBER CUJ!1PANY <br />State Cert. or Regist. # <br />Signature City License Registration #F <br />~~~~~~ ~~~~~~~~~~~~~~~~~*~~~~~~~*~~~~~t~*~ <br /> <br />KE,CHANlICAL COMPANY <br />State CerL or RegisL i!' <br />Signature City License Registration # <br />t~~~~~~~~~**~~~~~~*~~*~~*~~~*~~~~~~~~~~*~~ <br /> <br />OTHER C'lOOIPANY <br />State Cert. or Regist. # <br />Signature Ci~ License Registra~ion # <br />~~~~~~ ;~~~~~~~~~~~~~*~*t*tt~~~~~~~*~*~~~t~ <br /> <br />APPLICATION APPROVED BY PF;lli"iIT OFFICER" <br />