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<br />API"LTCATIOiNl FOR PERMIT <br />CITY OF ZE:PiI'fiml LLS <br />lR[]lU..DI~G DJE:PAR1l'm:T.lNJT <br /> <br />OWER'S "AKR !/fl1c $eIrT/lc t'r;2/1 /,ifC , !'HONE <br />OWER'S ADDRESS Jt'J:;2/-..s-"'# #1//5 ~#I(.'-J <br />,ftYf/f ?~t:'- lit 1/'0 ;2-!lLU./ <br /> <br />LEGAl. DESCRIPTION: 1.01'(5) BLOCK SUBDIVISION <br /> <br />0;2-,;2.6-:;"/ - tJP/~ -()(7j? ()t7 - t?t/;2. tJ <br /> <br />7d;,?- J2r-7 <br />:Y :JJY~ <br />5 3ry / <br /> <br />Jon ADDRESS <br /> <br />PARCEL LD.# <br /> <br />h1QRK PRoPOsED:L~e~ Oo>nstruct~ Oill <br /> <br />_Addit.ion _Alteration _Repair <br /> <br />_Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_Demolish <br /> <br />PROPOSED USE: Single F3JlJlily <br />VC.ollmerCial <br /> <br />_KIF <br /> <br />_~ .of Units <br /> <br />_M/H <br /> <br />_Indust. <br /> <br />-,Swin. Pool <br /> <br />Other <br /> <br />_Restaurant & ! '~alth DepartJment Appr.oval <br /> <br />BUILDING SIZE: //1/ X /tl-~ ~ /.$ 6 fJ Square Feet. <br /> <br />16) <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMKERCIAL : <br /> <br />ATTACH (2) PLOT Pf 1~.lNlS &: (2) SEIS OF BlllII.DIlNlG PL.&\.OOS & (1) SET ENERGY FORMS. U <br />ATTACH (3) SETS 0: RlITIlHlNlG PLANS .& 0) SET ENERGY FORHS.H <br />*:e:COPY OF GOINlTRAC' mrQlIlJTIUlD. <br /> <br />PEllmI.TS REQTlfRSTEO <br /> <br />_ELECTRICAL <br /> <br />$ <br /> <br />.---: <br />j, ()::) q <br /> <br />Valuation .of T.otal r~nst.nlctian <br /> <br />_BUILDING <br /> <br />Flarida Pa\>:el[ Corp. <br /> <br />W.R.E.C. <br /> <br />AHP Service <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valu.ation .of Hechanical Installatian <br /> <br />_PUJMBING <br /> <br />GAS <br />~oc:: <br /> <br />ROOFIOOG <br />_Fr<me ~eel <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: <br /> <br />Other <br /> <br />JPT . <br /> <br />IS PRo.nJ:C'T IN FLOOD ZONE AREA? <br /> <br />1/ <br /> <br />FINISHED FLOOR ELEVA'ITOlNlS: <br /> <br />YES NO <br /> <br />*:e:*=*~ *****:e:******:e:*:e::e:**:e::e::e::e::e::e:*:e:********:e: <br /> <br />BUILDER Q()I!fpAlNrY <br />State Cer~. .or Regist. # <br />Signature City License Registration <br />.~~t~~ ~*~*~~~~~*~~~~~~~~~~~~~*~~~~~~~~*~~ <br /> <br /> <br /> <br />ET.ECTRICIAN aJm>MW ~~rt~ Et5Cl7l/~ <br />d ~ ~ S<a'e CerL or RegisL # <br />SiJmature ~~ ..- ... ~ Cit-:}" License Registration ~ 1l-:3 <br />** ." .-a:*'Ii:":e:****-f::e::e::e:-:e:*:e::e:**:e:*il::e::e:*****i1.,:e:****:e: <br /> <br />PLUKBER cmtPAm" CI/;(j(j fAJtl( ~/j <br /> <br />~ ~~2. ~ St:a~e Cert. .or RegisL 4ft f/... . <br />Sign.at:nre ~ .. . tCit:\" Licens~ Rpgistration :Ilt Lr;-r <br />:e:***:e:'i::. : ",**'~-f:**:e:**:e:*:e:*:e:c.**:e:****:e::e::e::e::e::e:*:e:***:e: <br /> <br />Signatur <br /> <br /> <br />COMPANY b.P#Y.R Ih/Z.e <br />St:ate Cert. or Regist. _ #F /If #~" ~,,~Z n <br />Cit.y License Registration t~ Bit <br /> <br />MECHANICAL <br /> <br />0'T1IER <br /> <br />Signat:ure <br /> <br />OOOIPM""Y <br />State Cert. .or Regist. # <br />Ci~ License Registrati.on ~ <br /> <br />~~t~~~ :~*~*~~~~~~~~~~~~~*~~~t**~t~~~~*~~~~ <br /> <br />APPI.ICATION APPROVE'!) BY <br /> <br />~~ s(jJl~"'^>- <br /> <br />PEmHT OFFICER_ <br />