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<br />API'LIGA.TION FOB. PERKI'f <br />CI'IY OF ZF~PllYRHILLS <br />BmLDlliG Dil',PARI1IfEN'T <br /> <br />OWNER · S ADDRESS <br /> <br />PIt:! /~ Kyd! K rcCJo./;? <br />.5:798 KDQ.5 EvELT <br /> <br />::s-roeE5 <br />l3L vLJ. N. <br /> <br />PHONE 81 3 ~ S'3L1- /4 z-B <br />LLG:AIZvJfl7't7 , R... <br />, <br /> <br />OWNER · S MAKE <br /> <br />JOB ADDRESS <br /> <br />CODL-Co AJ. al9t [ 8L_'/D. <br /> <br />zCPH,'fRH ILLS FL. <br />I <br /> <br />LEGAL DESCRIPTION: L.OT(S) <br /> <br />_BLOCK. <br /> <br />StlfBDIVISION <br /> <br />PARCEL LD.# <br />WORK PROPOSED:_lNlew Construction _Addition _Alteration _Repair ~nstall <br /> <br />V Sign <br /> <br />__Hove <br /> <br />/~eaolish <br /> <br />PROPOSED USE: Single Faaily <br />ve::.ercial <br /> <br />_KIF <br /> <br />_, of Units <br /> <br />_K./H <br /> <br />_Indust. <br /> <br />_S.n.-. Pool <br /> <br />Other <br /> <br />~estaurant &: Health Depar-=-ent Approval <br /> <br />BUILDING SIZE: (0 D X 21'0, <br /> <br />1770tf <br /> <br />Square Feet. <br /> <br />1'2:,-~ <br /> <br />Height <br /> <br />RESIDENTIAL : <br />COHKERCIAL : <br /> <br />ATTACH (2) PLOI' PI.ANlS &: (2) SEI'S OF BmLDING PL..l\MS &: (1) SET ENERGY FORMS. u <br />ATI'ACB (3) SETS OF BlITLDDilG PI.ANlS &: (1) SET mmRGY FORMS. ** <br />**COFY OF CONTRACT REQ1Jl1l'R:IID. <br /> <br />PElMlTS REQUESTED <br /> <br />/ <br />~BUILDING <br /> <br />$ <br /> <br />4DDD~0C) <br /> <br />valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power COrp. <br /> <br />W.R.E.C. <br /> <br />_MECBANICAL <br /> <br />$ <br /> <br />valuation of Mechanical Installation <br /> <br />_PUJK.BIHG GAS ROOFDiG <br />TYPE OF CONSTRUCTION: _Block _Fume ~teel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FI' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />/ <br /> <br />FIlNlISHED FLOOR ELEVATIONS: <br /> <br />YES NO <br /> <br />************...****....*.***..*.***.****** <br /> <br />CONI'RACI'OR SECTION <br /> <br />Signature <br /> <br /> <br />CO!tP.MIfY .::SDL.{"'T1-\.~A$-r r::: e r0, <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />s-rr::g:cre;-c.. fY\FG,. l~ . <br />C. ~ ~ os;<r<l/9 <br />376 <br /> <br />BUILDER <br /> <br />Sismature <br /> <br />COIIPANY <br />State Cert. or Regist. , <br />City License Registration f <br />***************.****.*****.*..************ <br /> <br />ELECTRICIAN <br /> <br />CO!tPANY <br />State Cert:. or Regist:. , <br />____~.,,__.__._ City License Registration f <br />********.*****.***********~*************** <br /> <br />PLtDKBER <br /> <br />Signature <br /> <br />CO!tPANY <br />State Cert:. or Regist:. , <br />City License Registration I <br />****.*********~*****.*****************.*** <br /> <br />KEC'BAIfi CAL <br /> <br />Signature <br /> <br />COI!tPANIY <br />State Cert. or Regist. f <br />City License Registration f <br />****.*.*****.**********~****************** <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLICATJOIi APPROVID BY ~ ~ s/!.<1/J /1)- ~ <br /> <br />PERKIT OFFICER. <br />