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<br />APPLICATIl>OO FOR PERHIT <br />CI'IY OF ZE:PlIYRllILLS <br />B1ITLDlliG DEPARDIE'RT <br /> <br />OWNER'S NAME <br /> <br />f,lhf <br />70)6 <br />~ <br /> <br />;J~~lJ "d. ~ <br />~ <br /> <br />if/u-/ . <br /> <br />PHONE 7Ff--01/( <br />'ktly!.h I F1- <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPI'IOlli/: LOT(S) <br /> <br />BL.OCK <br /> <br />S1JJ8DIVISIOl!il <br /> <br />PARCEL I. D. t <br /> <br />WORK PROPOSED :_lIew Construction <br /> <br />.-Jdd,ition <br /> <br />____ € e " ()~ t,.~.e. <br />_Alteration _Repa1r _Install <br /> <br />_Sign <br /> <br />_lIfove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: Single Faaily <br /> <br />-"IF <br /> <br />_, of Units <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_Swi..-. Pool <br /> <br />_K/H <br />/t. ~. tJ Other <br />, <br /> <br />_Restaurant &: Health Deparbaent Approval <br /> <br />Square Feet. <br /> <br />Height <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />RESIDENTIAL: <br />cottKERCIAL : <br /> <br />ATTACH (2) PLOI' PI.MiS &: (2) SEIS OF B1ITLDING PLUS &: (1) SET ENERGY FORKS. H <br />ATTACH (3) SEI'S OF BUILDDifG PLMS &: (1) SET mmRGY FORMS. "'.... <br />"'....COpy OF COl!ilTRAC'I" REQumED. <br /> <br />PERKIlS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <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 />_MECHANICAL <br /> <br />s <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUH.BING <br /> <br />GAS <br /> <br />ROOFlliG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block <br /> <br />_F'raIIe _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJEC'I" HI FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />........"'................"'........................................................................................................................................ <br /> <br />Signature <br /> <br />~ <br /> <br />CO~croR SECTION <br /> <br />WlIPANY G;., -rr'.v ('~rl-~(t;.." <br /> <br />~ J State Cert. or Regist. , <br />., City License Registration i ~Z? <br />**....*~....**....*............*....*............................*........"'....*........*........**............*.... <br /> <br />BUILDER <br /> <br />ELECTRICIAN <br /> <br />CO!IPANY <br />State Cert. or Regist. i <br />City License Registration , <br />........*....***....*........******....**............................*............***........***............ <br /> <br />A- Pb- <br /> <br />:JJ?' <br /> <br />Sismature <br /> <br />Signature <br /> <br />- <br />I " ,.,_ -' <br />COIIPARY .. 'r .." <br />State Gert:. lor Regist:. :f# <br />City License Registration I <br />*........****........*........***....*............***....*........*................................*****.... <br /> <br />PUmBER <br /> <br />WllPANY litIIuAl'- <br />State Cert. or Regist. , <br />City License Registration I <br />....*....********........*...****........"'.~ .:l:....***........************ <br /> <br />KECHAlfICAL <br /> <br />Signature <br /> <br />/~;:) <br /> <br />OTHER. <br /> <br />Signature <br /> <br />WllPAl!iIY <br />State Cert. or Regist. i <br />City License Registration i <br />****....******....*****........***....*.~*....*....****....**r**** <br /> <br />0-P' /\~ <br /> <br />APPLICATION APPROVED BY <br /> <br />!iJl'."" ~ - ~ <br />, <br /> <br />PERMIT OFFICER. <br />