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<br />AI'l"1~rChT.I01l1 }<;()R :l:E!~!TT <br />C.I'IY OF ZEPiIymrU.LS <br />lUJf1..LDIBG DEPARI1liI!..ISi!' <br /> <br />O^"NER'S <br /> <br />~AME__....Sot/M/A-Nd COV P <br />/ <br />ADDRP_SS 13 CJ 0 L-.e-.c )2 odd <br />6~~ AYE <br /> <br />PlIONt(t/O 7 ) <br /><5 J2/AAldo, r/4. <br />( <br /> <br />%"NY.R' S <br /> <br />:528/0 <br /> <br />JOB ADDRESS <br /> <br />9D?- <br /> <br />LEGAL DF.SCRI:rTION: Wf(S) B '7 "/0 <br />, <br /> <br />BI.OCK./~ 7 SOBDIVISIO~ ?.E,/Jh't /l )11/ Jc:;z. <br /> <br />:PARCEL LD.' <br /> <br />h"ORK PROPOSED:_~ew Const:nlction ~dit:ion _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_Deaolish <br /> <br />_(:oauercial <br /> <br />~ust. <br /> <br />_S",i.. 1>>001 <br /> <br />_MIll <br />f.e~o/e t-- <br /> <br />Other <br /> <br />P.J~_QrPSf~..l? USP.: <br /> <br />Single Faaily <br /> <br />_KIF <br /> <br />_' of Unit.s <br /> <br />_Restaurant: & fiea It:h Deparblent Approval <br /> <br />!1Ul,I.DING SIZE: <br /> <br />x <br /> <br />Square Feet:, <br /> <br />Heiehc <br /> <br />RESIDENTIAL: AITc\CJl (2) PLOT PIM':; & (2) SEfS OF' mITI.DIINIG l)I..'\~S & (1) SET IDU:RGY I-'Um1~;. H <br />CO~^'.l'{ERC..IAL: ATIc\OJ (3) SF':TS m~ II, iJII.DDilG PLANS & (I) SET ENE'RGY POR~ts. *~ <br />i1:*COPr OF cowrRACl' H .;QIlHRIID. <br /> <br />PERI/fiTS REQUf'$TRD <br /> <br />____r5tJTLD.ING <br /> <br />$/4./1/:;-<:50 <br /> <br />, <br /> <br />Valuat:ion of Tota], f'.onstnlction <br /> <br />__Y.LE(''TRI CAl. <br /> <br />AKP S(' cvice <br /> <br />Plorida PO\f:'C r Co rp . <br /> <br />_W.R.E.C. <br /> <br />___HECHAl\ICAL <br /> <br />'\) <br /> <br />valuation of lPiecbanical Inst:allation <br /> <br />__PLUMBING GAS <br />/ <br />TYt>E Of' CONSTRUCTION: ~Block <br /> <br />ROOF'D1G <br /> <br />SPI~CIALTY <br /> <br />_Fra8e _St.ee1 <br /> <br />Other <br /> <br />FHfISJIED FLOOR F.:LEVATlONS: <br /> <br />F'\. <br /> <br />IS PROJECT IN FLOOD ZONE .(\REA? <br /> <br />YES NO <br /> <br />*****.**~~*************************..***** <br /> <br />allll1TRACTOR SECTION <br /> <br />S ig,na t:nre <br /> <br />-~- <br /> <br /> <br />COKl)ANY M .D ' Bvi/~l/5:. , <br />Stat:e Cert:. or Reg i~it., I <br />/' CiLy License Registration II <br />******************************* <br /> <br />LA/C-- . <br /> <br />,~6;;Z <br /> <br />JJDlJ.J).ER <br /> <br /> <br />, <br /> <br />mHPANY [) ;../4VV~'7 E / c. (/ ________. <br />State Cert:. or Regis t.. 4# .R Je ~O '5 ~:J 2.,.. <br />City License Regist:rat.ion t r2 Y_f .- <br />~******************************** <br /> <br />s ir~n.a ture <br /> <br />cmwMry_0~ Eo C 11r2/' 5 h It t-J'S (3'10 ~ LI3 ~ ',__ <br />~ ~ -4.' Sica"" (:ert_ or Re(:isL # {'Fr:cr "'<'L_ <br />~? 2-C- 'A1/.2.b77 City License RegiS(Tat101l I _ /..57 <br />********~*****.********************~****** <br /> <br />.:rI.!r':"~1\J%_ <br /> <br />CO'lfPAHY__ <br />St.ate Cert.. or Reg i sf:. it <br />City License Registration it <br />********~*****.***********~*************** <br /> <br />~~g,t~KI.(:A T. <br /> <br />Signature <br /> <br />. <br /> <br />cmfPM"Y <br />State C(~rt:. or RegisI'. II <br />CiI:y License Rcgisl.lation , <br />***..***~*******************.************* <br /> <br />.QTI!'P.R <br /> <br />, <br /> <br />Sign.ature <br /> <br />APPL.ICATION APPROVED UY <br /> <br />PERMIT OFFICER. <br />