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<br />OWNER' S <br /> <br />--::> <br />IiAttE ~~ d€-r- <br />ADDRESS tP L( I S <br />R1. <br /> <br />APPLICATI05 FOR pERKIT <br />CI'IY OF ZEnlIKH II.T_c; <br />BUIIJ)DiG DEPAR:I'ftr;Jft <br />GYl!,rOLJqr- <br />6(Jj,,~ ~a0 r~ moD <br />~'~i~~""'- _,/ J~ <br />'1.. '-- <br /> <br />7Rr -4 770 <br />~/U~ (ja.J('5 <br /> <br />OWNER' S <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCIUPTIOlI: wr(s) <br /> <br />BI:.OCK <br /> <br />SUBDIVISIOR <br /> <br />PARCEL I. D. f <br /> <br />WORK PROPOSED :_lNJev Construction .-JYIdition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_ne.olish <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_, of Units _K/B <br />_SwiJa. Pool ~rq/~~_Ot:her <br /> <br />PROPOSED USE: single Faaily <br /> <br />_KIF <br /> <br />~t:.auraIlt &: Healt:h ))epa.rt:.eIlt Approval <br /> <br />BUILDDlG SIZE: <br /> <br />x <br /> <br />~e Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COttttERCIAL : <br /> <br />ATTACH (2) PLOt PLAlIS &: (2) SETS OF BUIIJ)TIiG PLAlNJS &: (1) SEI' ENERGY FORKS. ** <br />A1TAaI (3) SETS OF BUIIJ)DIG PLDS &: (1) SEI' DRRGY FORKS.** <br />**OOPf' OF OORTKACT KEQOIRED. <br /> <br />PI11IlIf1TS "RJl'.OOESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Tot:a1 Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />~CAL <br /> <br />$ <br /> <br />valuation of Hecbanica1 Installation <br /> <br />_PLUKBDlG GAS KOOFDIG <br /> <br />SPECIALTY <br /> <br />TYPE OF OOIiSTIWCTIOR: _Block ~ _Steel <br /> <br />ot:her <br /> <br />FI' . <br /> <br />IS PROJECT DI FLOOD ZONE AREA! <br /> <br />FIllISBED FLOOR ELEVATIOIiS: <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />aJIIJI'RACIOR SECTlOR <br /> <br />Signature <br /> <br />CDltPAJIY <br />State Cert. or Regist. I <br />City License Registration I <br />****************************************** <br /> <br />RmT.DF.Il. <br /> <br />RI.F.CTRICIAH CDltPMIY <br />State Cert. or Regist. i <br />Si..nature City License Registration f <br />****************************************** <br /> <br />PUllBEK :~ ,A /! =~~fi;{i1~'-- p~~,~ <br /> <br />Signature ~ ~~ ~ City License Registration f /~~<\ <br />- <br />*****.*--*~..-*~~~~~~~~~~*************** <br /> <br />KEaIAlfiCAL aJIIPARY <br />State Cert. or Regist. f <br />Signature City License Registration f <br />***********.AA&a************************** <br /> <br />flTRF.R COIIPAIIY <br />State Cert. or Regist. f <br />Signature City License Registration f <br />****************************************** <br /> <br />APPLICATIOIi APPROVED BY pERIIIT OFFICER. <br />