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<br />APPLICATION FOR PRRKIT <br />GI'IY OF ZEPIIYRIITLLS <br />BillIDlliG DEPA.RI1IIE:Nr <br /> <br />OWNER'S NAME <br /> <br />JIll f2 rZ$U, So F?-~ lid <br />;;->/1 if/lJt $/--1/,1> <br />-;; f1/~ S &- v /1 ~g A1' .IlL.L-- <br /> <br />PIIOH <br /> <br />7 g.>- 6677' <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />C /lP~ <br /> <br />!./ /~ <br /> <br />LEGAL DESCRIPTIOI!i: WI'(S) <br /> <br />BL.OCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D. f <br /> <br />WORK PROPOSED :_lIew Construction <br /> <br />_Addition <br /> <br />VAlteration <br /> <br />_Repair <br /> <br />_Install <br /> <br />_Sign <br /> <br />_!!love <br /> <br />_Deaolish <br /> <br />PROPOSED USE: Single F3Blily <br />d~rCial <br /> <br />_KIF <br /> <br />_, of Units <br /> <br />_M/H <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />Ot:her <br /> <br />_Rest:aurant & Health Deparblent Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL : <br />COMKERCIAL : <br /> <br />ATTACH (2) PLO!' PIJ\.NS & (2) SEIS OF BUILDING PLUS & (1) SET ENERGY FORKS. ** <br />ATTACH (3) SEIS OF BUllDDlG PLUS & (1) SET ENERGY FORMS. ** <br />'I:*COPY OF CONTRACT REQm:RED. <br /> <br />PElMITS REQUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Tot:a1 Construct.ion <br /> <br />_ELECTRICAL <br />bClWilCAL <br /> <br />AKP Service <br /> <br />Florida Power COrp. <br /> <br />W.R.E.C. <br /> <br />s <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFTIiG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block <br /> <br />_Fr3liie _Steel <br /> <br />Ot:her <br /> <br />FIlfiSHED FLOOR ELEVATIONS: <br /> <br />FI' . <br /> <br />IS PROJECT IN' FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />*'1:*'1:'1:*'1:***'1:**'1:*****'1:*'1:****'1:'1:***'1:'1:*'1:***'1:*'1:* <br /> <br />COlln'RACTOR SECTION <br /> <br />BUILDER <br /> <br />Signature <br /> <br />COMPMUY <br />State Cert. or Regist. ~ <br />City License Registration ~ <br />***'1:*****'1:*'1:'1:'1:****'1:'1:****'1:*'1:'1:*'1:*'1:'1:*******'1:* <br /> <br />Si <br /> <br /> <br />OO1IPANY f"r ~..,I /'" ~~t) 6 -/~ c.: '-/ <br />State Cert. or Regist. ~ <br />City License Registration t /~'"2/ <br />'1:'1:*'1:**********'1:'1:'1:*********'1:*'1:'1:'1:*****'1:** <br /> <br />ELE <br /> <br />PUlIKBER <br /> <br />Signature <br /> <br />COMPANY <br />State CerL or RegisL ~ <br />City License Registration t <br />..*.*~~.*.*~~~~~+~~~~~~~~~~~.~~~sz~~x:~x** <br /> <br />KECllAliICAL COlfPANY <br />State Cert. or Regist. I <br />Signature City License Registration , <br />'1:'1:'1:*****'1:************'1:'1:*****************'1:'1: <br /> <br />OTIIER. CO'!fPANY <br />State Cert. or Regist. t <br />Signature City License Registration , <br />****************'I:*'I:****~***'I:***'I:**'I:*'I:*'I:'I:** <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />