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<br />APPLICATIOl!il FOR PERHIT <br />CITY OF ZEmYRBILLS <br />BUfIIJHl!iIG DEPARl1llEl!ilT <br /> <br />OWER'S <br /> <br />NAME ~0Ni. s t!/./Ur ((' <br /> <br />(!~~~ <br /> <br />PHONE <br /> <br />OWHER'S ADDRESS <br />JOB ADDRESS Co d ( ~ <br />LEGAL DESCRIPTION: LOl'(S) <br /> <br />tL-:", ~,,\ 1 {~'>Y\ <br /> <br />'" <br />?) { {' v~ -R- <br /> <br />;'\-;'1 v .Q ( ()c If' c:; <br /> <br />BI.OCK <br /> <br />SllfBDIVISION <br /> <br />PARCEL I. D.' <br /> <br />WORK PROPOSED:_lN!ev Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />_KIF <br /> <br />_' of Units <br /> <br />_K/H <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />Other <br /> <br />_Restaurant &: Hea1t:h Depar~t Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL : <br />COHKERCIAL : <br /> <br />ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLAl!iIS &: (1) SET ENERGY FORKS.** <br />ATTACH (3) SETS OF BUII.DDlG PLMS &: (1) SET ElIiIERGY FORKS. ** <br />**COPI' OF COIITRACT REQlJJDIID. <br /> <br />PEmfITS REQUESTED <br /> <br />_BUlLDHIG <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 />_HE~CAL <br />.......'. <br />~/ <br />'~UKBING <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />GAS <br /> <br />ROOFDlG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block <br /> <br />_Fra.e _Steel <br /> <br />.. <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FI' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />CO"liTRACTOR SECTION <br /> <br />BUILDER <br /> <br />CIJl!tPANY <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />ELECTRICIAN <br /> <br />COIfPANY <br />State Cert. or Regist. # <br />City License Registration , <br /> <br />*~***"*"""****::"ctr:~;:;'lj' ~~i~r^f ' <br /> <br />State Cert. or Regist. i <br />City License Registration I /~ ~ <br />****************************************** <br /> <br />Sismature <br /> <br />( <br />PWKBER \ / <br />SigDarore ~dtJ <br /> <br />MEalANICAL COlfPMY <br />State Cert. or Regist. , <br />Signarore City License Registration I <br />****************************************** <br /> <br />0T1IER COlIPANY <br />State Cert. or Regist. I <br />Signarore City License Registration , <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERKlT OFFICER. <br />