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<br />APPLICATIOII FOR PERKIT <br />CITY OF ZEPIIYRBILLS <br />Bm::tDIlIIC ,DEPAR'IKEIn' <br /> <br />OWNER I S MAKE <br /> <br />L u..C I i..L ~ UJi siJ I E Lv 5' k i <br />J] U "11211- trt ':0 II . <br />lfE1..iRft-/Yt ''bI2... <br /> <br />mmm <br /> <br />7P,,2, -- tJ S- ~ S <br /> <br />OWNER'S ADDRESS J.... 3:2. 8 <br /> <br />JOB ADDRESS <br /> <br />r.f;(R <br /> <br />LEGAL DESCRIPTIOlIf: wr(S) RT,OCK SUBDIVISIOII ZCIJIf X€.. /ffJ6tfl:S- <br />PARCEL LD.I )2 ~ 2./" -~l- DDJ' D -1!Jt9~()O -171),,'-0 <br /> <br />WORK PROPOSED:_5ev Construction ~tion _Alteration .--Repair _Install <br /> <br />_Sign <br /> <br />_!!love <br /> <br />_Deao1ish <br /> <br />PROPOSED USE: .--single Faaily <br /> <br />_"IF <br /> <br />_, of Units <br /> <br />_K/H <br /> <br />_~rcia1 <br /> <br />_Indust. <br /> <br />_Swia. Poo1 <br /> <br />Ot:her <br /> <br />_Rest:.aurant &: Bea1t:h Depa.r1:IIent Approva1 <br /> <br />BtnLDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDEIfTIAL: <br />cottItERCIAL : <br /> <br />ATTACH (2) PLOI' PI...AliS_ &: (2) SEI'S OF BUILDING PI...MS &: (I) SET ENERGY FORMS. ** <br />ATI'ACII (3) SEI'S OF BUILDDiG PLUlS &: (I) SET ENERGY FORMS.** <br />**COPY OF COlITRAct RIlQm:RIlD. <br /> <br />PERKITS REQUESTED <br /> <br />_BUILDING <br /> <br />$~ <br /> <br />Va1uation of Tot:a1 Construction <br /> <br />$ <br /> <br />AfIP Service <br /> <br />I 'i7S~ aL- <br /> <br />F10rida Power COrp. <br /> <br />W.R.E.C. <br /> <br />_ELECTRICAL <br />~fmawuCAL <br /> <br />Va1uation of Kechanica1 Inst:allation <br /> <br />_PLUKBTIfG <br /> <br />GAS <br /> <br />BOOFDiG <br /> <br />SPECIALTY <br /> <br />.. <br /> <br />TYPE OF CONSTRUCTION: _B1ock _F'raIIe _Stee1 <br /> <br />Ot:her <br /> <br />FlliISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJEct Di FLOOD ZOBE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />COJIi1I'RACIOR SECTION <br /> <br />81TH llER <br /> <br />Signature <br /> <br />COIfPANY <br />State Cert:. or Regist. I <br />City License Registration I <br />****************************************** <br /> <br />ELECTRICIAH <br /> <br />COIfPdY <br />State Cert. or Regist. I <br />City License Registration f <br />****************************************** <br /> <br />SiPf1~ture <br /> <br />PLUKBER <br /> <br />COIfPARY <br />State Cert:. or Regist:. I <br />City License Registration f <br />****************************************** <br /> <br />Signature <br /> <br />Signature <br /> <br />(\ 11 LA / ="~~~r tt::"~t4{t /1#~f <br /> <br />t:J 11/1../1# ,-h~ City License Registration f I ~ '1 <br />*******..********************************* <br /> <br />KECIIAlfICAL <br /> <br />0'I'1IfJr <br /> <br />Signature <br /> <br /> <br />COIfPARY <br />State Cert. or Regist. I <br />City License Registration f <br />*********** ************* *** <br /> <br />APPLICATION APPROVE'D BY <br /> <br />PERKIT OFFICER. <br />