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<br />APPLIC..ATIOJN: FOR -PRmUT <br />CITY OF ZE.'PIIYRIITLLS <br />BlJJILDUl1G DEPAR'1l'fE',N'T <br /> <br />;;b'7-j9':3~ ~ <br />01 <br /> <br />OWNER'S NAME <br /> <br />.1, ... <br /> <br />,. ;); 0 t~,.I-Iff j(ER-, <br />st/~ . . /~ff ';;1- <br />3"~~ <br /> <br />P1tO~E <br /> <br />7gY:L-(06~b <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRP..sS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION! <br /> <br />PARCEL LD.# <br />h~RK PROPOSED:____~ew Construction ____Addition ____j\lteration ~RePair ____Install <br /> <br />____Sign <br /> <br />____Hove <br /> <br />____Demolish <br /> <br />PROPOSED USE: <br /> <br />)( Single F3IIIily <br /> <br />~K/F <br /> <br />____it of Units <br /> <br />_M/H <br /> <br />_Coaaercial <br /> <br />____Indus t. <br /> <br />_Swim. Pool <br /> <br />Other <br /> <br />_Restaurant &: Health Deparbment Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Fee t. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COHHERCIAL : <br /> <br />ATTACIT (2) PLOT PLAN!~ &: (2) SETS OF nutLnING PLANS & (1) SET ENERGY Fb~~.** <br />ATTACH (3) SETS OF BUILDING P"LANS &: (1) SET ENERGY FOR~IS. H <br />:!-:!-COPY OF CONTRACT RlJ'.QUIRllD. <br /> <br />PRlMITS RF.oUP-'iTED <br /> <br />L-BUILDING <br /> <br />XELECTRICAL <br />{I/ It- MECHANICAL <br /> <br />$ <br /> <br />?c//s <br /> <br />Valuation of-Total ConstnJction <br /> <br />MfP Service <br /> <br />Florida Prni'er COrp. <br /> <br />W.R.E.C. <br /> <br />s <br /> <br />Valuation of Mechanical Installation <br /> <br />XPLUMBING GAS X ROOFING <br />TYPE OF CONSTRUcr:rON: ____Block ~Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FINISJIED FLOOR EL.EVATIm~S: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE ARR~? <br /> <br />*:!-:!-:!-:!-~*********************:!-************** <br /> <br />YES NO <br /> <br />ro_'::~F.CT5d'#,t?Y' ~c7J ~ .L~ <br /> <br />State Cert. or Rcgist. lit t!?.4Jt!! O/P~.,:2..J <br />City License Registration # <br />************************************* <br /> <br /> <br />HI.RCTRI CI AN <br /> <br />, ampANY (VI (J./1-,,,,- (f t <- 'f.r. ~ <br />7fl /1. ?" ~ _ L Stat.e Cert. or l~egist. ifi: CI(N) (/110 <br />~1T [J-.. f ~~ City License Registration # r;,,J <br />********* *****.****************~********* <br /> <br />Sismature ,/ <br /> <br />PfE'.Cl1'ANICAL <br /> <br /> <br />coHPANY-:,4c ~ ;!-/~S/rl-5 <br />// . State Cert. or RegisL t# ~ <br />~ City License Registration i <br />****************************************** <br /> <br />PI.UKnER <br />Signature ~k! <br /> <br />Signature <br /> <br />GO'lfPANY <br />State Cert:. or Regist. if <br />City License Registration ~ <br />~~*XZ~X*X~.~*X*~**~~*~~~~~*~~~~~~~ <br /> <br />0"TlTY.R , _ <br />. /?Oi,fJ~r /' <br />S1gnature <br /> <br />roHPANY <br />State Cert. or Regist. * <br />City License Registration * <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMlT OFFICER. <br />