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<br />APPLICATION FOR PE:Ilh"HT <br />CIn OF ZE:Pffi'P.UU.I,S <br />lR1IIfllJlll~G j.i1EPAR:1fHElhIT <br /> <br /> G\ ~ \ ~ <. of :, ~ \'\\ Oo.t \, tOY' \I~\ /.- ~~l'rllo1 c.t:,(\ .~~( 91'1 - z. t:. 1."<- <br />OWNER'S NAME ~\'l <br /> \\ T::,\ (\J 'b'(" \ ~ _4. '" S-~~ -t. C- \. --- f"'L 3 ~b I <- <br />OWNER'S ADDRESS \'J ' \ 0...\4'\ f' <br /> J <br /> ~l 9\"5 " \., f\ '\, t.. 'Vl...)\- LC.~~~ t t-- '; \ l Tl. <br />JOB ADDRESS \s- '] <br /> / <br /> <br />LEGAL DESCRIPTION: W:r(S) <br /> <br />B.LOCK <br /> <br />SIJJBDH"IS10iN! <br /> <br />PARCEL I. D . :# <br /> <br />h'ORK PROPOSED :_!Keti' Const:ruct on <br /> <br />_Addition _Alteration _Repair ~nstall <br /> <br />_Sign <br /> <br />_I!fove <br /> <br />_DeDlOlish <br /> <br />PROPOSED USE: <br /> <br />Single F3JllIIily <br /> <br />_KIF <br /> <br />_, of Units <br /> <br />_M/H <br /> <br />_C..oumercial <br /> <br />_Indust. <br /> <br />_SW'im. Pool <br /> <br />Other <br /> <br />_Res1taurant lie i.ealt:h Deparment: Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />'- <br /> <br />Square Fee t., <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COHHRRCIAL : <br /> <br />A'ITAClI (2) PLOT prANS &: (2) SILTS OF BUILDING PLMilS &: (1) SET ENERGY FORMS. U <br />ATTACU (J) SETS G, IUTIUHJS1G PI.A.NS &: (l) SET ENERGY FOR1.'1S.-::-:: <br />~-::COPY OF COWfItAC' REQlUTlIRED. <br /> <br />PEmlITS RR,QUHSTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />V500, <JO <br /> <br />Valuation of ToL"1l Construction <br /> <br />_ELECTRICAL <br /> <br />AHP Service <br /> <br />Florida PO\>l"'C r f'.orp. <br /> <br />W.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Va1ua1tion of !Mechanic.al Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />x <br /> <br />SPE,CLUTY <br /> <br />TYPE OF CONSTRUCTION: _Bloc!: <br /> <br />_FraJDje _Steel ~"5o... ~~ ~Y'-... Other <br /> <br />FINISHED FLOOR ELE:VATIOINJS: <br /> <br />_iPT . <br /> <br />IS PROJECT IN FLOOD ZOINJE AREA? <br /> <br />YES NO <br /> <br />~~*~~~ ~*~~~~~*~~~*~~*~~~~~*~~~*~~*~~~~~*. <br /> <br />OOl!iJ"fRJ\CTOR SECTION <br /> <br />Bun.DER <br /> <br />OOI!fPMIlY <br />St:ate Cert:. or Regist:. *' <br />City License Registration 1# <br />**~-::~~ ~****~**~~~~**~~**~~-::-::~~~~~~-::**~*~~ <br /> <br />Signature <br /> <br />ELECTRICIAN OlMfPANY <br />State Cert:. or Regist. #< <br />Shmature City License Registration f <br />~~*~*~ ~~***~***~~***~~~**~-::~*~~~**~***~r~ <br /> <br />PLlJIHBER <br /> <br />C'OlnPA1N1Y <br />Stat.e Cert. or Regist. # <br />Cit.y License RegistraI:ion # <br />~*~*~~"-::**~~~~~~***~~~~*~~~*-::*~~~~-::*-::~-::-::~* <br /> <br />Signature <br /> <br />KECHAKICAL <br /> <br />Clll'lfPMIiY <br />Stat.e Cert. or Regist.. # <br />City License Registration I <br /> <br />Signature <br /> <br />tA~A~~ ~~~t*~~~*~~*~*~*~~~~~~~*~~~~~~*~~~~ <br /> <br />~~~~~~~~~~~~~*~~~~~~~~~*~~~~~~~~~~~ <br /> <br />" <br />OOJWk"lJY ~~~")\.., ~,,;::-~~,\;-~,,-- <br />S~ate Cert:. or Regist. 1# <br />Cifty License Registration 1# 6, 7j 7 <br /> <br />0TlIER <br /> <br />i~~ <br /> <br />S ign..ature <br /> <br />APPLICATION APPROVED BY <br /> <br />PE:&lfIT OFFICER. <br />