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<br />APPLICATI05 FOR PERKIT <br />CIn OF ZEPIIYRIIILLS <br />BtITI.DDiG DRPARDIEIIiT <br /> <br />OWER'S NAME 'V\c..-'G cQv.>\'c ~O~ ~eES)lrvC. PIlOn ~\~<.l1-3?>'l2 <br /> <br />lNBER'S ADDRESS ~.0. ~o>-};~52 =rhrDrf<J * ~l>~3b <br />JOB ADDRHSS CoD ~ ~ ____ <br /> <br />LEGAL DESCRIPTION: LOI'(S) <br /> <br />BI.OCK <br /> <br />SUBDIVISI05 <br /> <br />PARCEL I. D. t <br /> <br />WORK PROPOSED:_5ev Construction ~ition _Alteration _Repair _Insta11 <br /> <br />~ Sign <br /> <br />_I!tove <br /> <br />_Deao1ish <br /> <br />PROPOSED USE: <br /> <br />Sing1e F:HIi1y <br /> <br />_KIF <br /> <br />_, of Units <br /> <br />_KID <br /> <br />~ ~rcial <br /> <br />_Indust. <br /> <br />_Swill. Poo1 <br /> <br />Other <br /> <br />_Restaurant &: Hea1t:h Depart:.ent Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDERTIAL : <br />COHKERCIAL : <br /> <br />ATl'AGH (2) PLOI' PLUS &: (2) SEI'S OF BUILDING PLUS &: (1) SET ENERGY FORKS.** <br />ATTACH (3) SEI'S OF B1JD.DDiG PLUS &: (1) SET mmRGY FORKS. ** <br />**COPr OF CONTRACT KEQ1JJIRIID. <br /> <br />PERlllITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />s- . s 'is. ~O <br /> <br />Valuation of Tot:a1 Construction <br /> <br />_ELECTRICAL <br /> <br />AIfP Service <br /> <br />F10rida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHANICAL <br /> <br />s <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUKBING GAS KOOFDiG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _FraIIe _Steel <br /> <br />Other <br /> <br />FDfISHED FLOOR ELEVATIONS: <br /> <br />FI' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />Signature <br /> <br />CODn'KACIOR SECTION <br /> <br />COKPANYffiA~~~J Cof.)~dt~,0 <br />State Cert:. or Regist:. # C J,gc'O 1 'l. ~7 z:. <br />City License Registration , <br />****************************************** <br /> <br />BUILDER <br /> <br />ELECTRICIAN <br /> <br />COKPANY <br />State Cert:. or Regist. , <br />City License Registration I <br />****************************************** <br /> <br />Silmature <br /> <br />PLDlBER <br /> <br />Signa.t:.u.re <br /> <br />COKPARY <br />State Cert. or Regist:. I <br />City License Registration t <br />****************************************** <br /> <br />KEClIARICAL <br /> <br />Signa t:.u.re <br /> <br />COKPArIY <br />. State Cert:. or Regist:. t <br />City License Registration I <br />****************************************** <br /> <br />OTHF.R <br /> <br />Signat:.u.re <br /> <br />COKPAIiY <br />State Cert. or Regist:. I <br />City License Registration I <br />****************************************** <br /> <br />APPLICATIOB Al'PROVED BY ..'-.1-1dAA~:>f! OA~ <br /> <br />PERKIT OFFICER. <br />