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<br />APPLICATIOIl FOR PERHI.T <br />CITY OF :z.EPBYRHILLS <br />BmLDIB'G DEPARnIE'.lNI'T <br /> <br />OWER'S NAME In/? -J yn 1'( S <br />OWNER'S ADDRESS ~ ~ I (( <br />~$/lm6 <br /> <br />f ./lJl.<'I7~ <br />C~ Iih1 en <br /> <br />~ <br />sT <br /> <br />P1IOlliJE <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPl'IOl!lll: IDI'(S) <br /> <br />BJ...OCK <br /> <br />SUBDIVISIOlNl ,C) A/( c::::, ,'-J <br /> <br />ryl9tel( <br /> <br />PARCEL I. D . f <br /> <br />WORK PROPOSED:_lNIev Construction -.AJwdition _Alteration _Rep.....ir _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />Single F3IIIily <br /> <br />_KIF <br /> <br />_, of Units <br /> <br />_H./H <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_Swa. Pool <br /> <br />Other <br /> <br />_Restaurant &: Health ~t Approval <br /> <br />BUILDING SIZE: /0 X 1/ , <br /> <br />Square Feet. /' ~O <br /> <br />Height <br /> <br />RESIDENTIAL : <br />COKKERCIAL : <br /> <br />ATTACH (2) PLOI' PI.A5S &: (2) SEI'S OF BlllLDIlNIG PLAlNIS &: (l) SET ENERGY FORMS.** <br />ATTACH (3) SETS OF BUILDDlIG PLM!JS &: (1) SET RlNIERGY FORKS. ** <br />......COPY' OF COlNlTRAC1' REQm:RED. <br /> <br />.. <br /> <br />PEmlITS REOUJRSTED <br /> <br />V-;-UILDING <br /> <br />$ <br /> <br />900 <br /> <br />Valuation of Tot:al Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_H.ECllAlUCAL <br /> <br />s <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBTIlG GAS ROOFDiG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCl'IOIl: _Block ~3IIe _Steel <br /> <br />Other <br /> <br />FIlNIISHED FLOOR ELEVATIONS: <br /> <br />FI' . <br /> <br />IS P.RO.JEC1' IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />......***..................*............*.......**...*.*.******* <br /> <br />COJn'RACI'OR SECl"IOlNl <br /> <br />BUILDER <br />Signature ~ <br /> <br />f..JLJ ,;~ <br /> <br />CO!fPMllY 111 {I<e CD .t II ~ A III S C! 6 ,uS /Rue].. b-., <br />State Cert. or Regist. I <br />City License Registration I <br />.*.......*....*...........*.............*.*......*..*...** <br /> <br />.-:;:J t-<;; </ <br /> <br />Si!mat:ure <br /> <br />COlIPAlNIY <br />State Cert. or Regist. I <br />City License Registration t <br />..***......*...*..***.**.........*.*....********** <br /> <br />ELECTRICIAN <br /> <br />CO!fPAlNIY <br />State Cert:. or Regist:. 1# <br />City License Registration # <br />****...*..................**....*..*........**...********* <br /> <br />PLUJKBER <br /> <br />Signat:ure <br /> <br />CO'IfPAlNIY <br />State Cert. or Regist. # <br />City License Registration I <br />...*...*.*............*.*.**...*...........*......*...*......*.**...****...... <br /> <br />H.E'.GIIAlU GAL <br /> <br />Signat:ure <br /> <br />a>>IPAlNIY <br />State Cert:. or Regist.f <br />City License Registration , <br />***...*****..............**...**...*......*............*********** <br /> <br />01'1IER <br /> <br />S ignat:ure <br /> <br />APPLICATION APPROVED BY <br /> <br />PERHIT OFFICER. <br />