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<br />APPLICA'TIOJl FOR :?ERKIT <br />CITY OF ZEPllYRHU.LS <br />B1JILDlliG DEPARDDJ'NT <br /> <br />OWNER'S ADDRESS <br /> <br />Co I\)Q. \ ('L <br />1133s <br />1~'-\~ <br /> <br />.l r0~ mOIm ~6\) 1~3-gLj1 0 <br /> <br />/ <br />G~\\ ~\0d. ?-r:: fkj\ l; ll~ ) f=l~ <br />~\uJ. 2~ p\:-y f ~\ \\ L / \= \0 <br /> <br />OWNER I S HMtE <br /> <br />JOB ADDRESS <br /> <br />6-0.. \ \ <br /> <br />LEGAL DESCRIPTION: UJI'(S) <br /> <br />BLOCK SUBDIVISIO~ <br /> <br />/! ~ / ?OA~~ Svv <br /> <br />.--JWd,ition AlteratiL _Re~ir _Install <br /> <br />PARCEL LD.' <br /> <br />WORK PROPOSED :_Jlev Construction <br /> <br />_Sign. <br /> <br />_ftove <br /> <br />_De-.olish <br /> <br />PROPOSED USE: <br /> <br />~ingle Faaily <br />_ec:-ercial <br /> <br />_KIF <br /> <br />_, of 1JJnits <br /> <br />~K/H <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />Other <br /> <br />_Restaurant &: Health Depart.ent Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL : <br />COHHERCIAL : <br /> <br />ATTACH (2) PLOf l'L.OS &: (2) SETS OF Bm:LDING PLMlS &: (1) SET RHERGY FORKS. u <br />ATTACH (3) SETS OF BlITLDlllG PLANS &: (1) SET ENERGY FORRS.** <br />**COPY OF COIi1TRAGT REQmr:RED. <br /> <br />PERKITS REQUESTED <br /> <br />_BUILDING <br /> <br />~ - <br />$ -,?-?"')d?O <br />____ J C-/O' <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 />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLmtBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTIOJl: _Block _Pralle __Steel <br /> <br />Ot..her <br /> <br />FINISHED FLOOR ELEVATIOHS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />******************t****~****************** <br /> <br />C01'iJTRACIOR SECTION <br /> <br />BUILDER <br /> <br /> <br />COI!fPMlY <br /> <br />Signature <br /> <br />ELECTRICIAN OOKPLUiY \Y\.::;o.." \.' \ \'\J <br />-x7 () . 21 "11A '-L 0 State Cert:. or RegisL #f: <br />Sif!ll3ture f'1~ / -I.-(;v./l--... t- City License Registration I <br />********* ******************************** <br /> <br />E \tc.\.(, c... <br />f:KQO /(((0 <br />Ifi' <br /> <br />COMPAlIiY l)c:...V'~ <br />~ State Cert. or Regist. #f: <br />City License Registration # <br />* ************************************** <br /> <br />, , <br /> <br />PWKBER ~ <br />Signature ~ <br /> <br />I'~' c \ 1 <{ ''\.,--1-' '; 3~ <br />"7 d- "( L. <br /> <br />KECHANICAL <br /> <br />Signature <br /> <br />L'1>>IPAlIiY <br />State Cert. or Regist. I <br />City License Registration j <br />********t********~***t******************** <br /> <br />OTHER <br /> <br />Signature <br /> <br />CO'!IPMfi <br />State Cert. or Regist. #f: <br />City License Registration i <br />*************~~****.*~******************** <br /> <br />APPLICATIOB APPROVED BY <br /> <br />PERKIT OFFICER. <br />