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<br />APPLICATIOH FOR PERHIT <br />CI'IY OF ZEPlIYRIIIll..S <br />BUILDIXG DEPARI'KE'.NT <br /> <br />0WIfER' S IWIE Jo (-- R.' n; <br />OWNER'S ADDRESS 1,5"/0 IJ /1 /9 5;""M <br />JOB ADDRESS <... ~~S-:-;:'j- <br /> <br />. <br />PlI0~ <br /> <br />93?-/r?b <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISIOINl <br /> <br />PARCEL LD.# <br /> <br />lroRK PROPOSED :_!II1ew Cons truction <br /> <br />~dd~ <br /> <br />_Sign <br /> <br />--.JIove <br /> <br />~l teration _Repair _Install <br /> <br />_D~ C.oiJO<- je-iJ?; ~II- vJ,A 'f <br /> <br />PROPOSED USE: <br /> <br />Single Fanily <br /> <br />_KIF <br /> <br />_* ot: Units <br /> <br />_M/H <br /> <br />_Coaaercial <br /> <br />_Indust. <br /> <br />_Swim . Pool <br /> <br />Other <br /> <br />_Rest:aurant & nealt:h Deparblent 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 Pl.J\.NS & (2) SETS OF BUIIJUINlG PlANS & (1) SET ENERGY FORMS. ** <br />ATTACH (3) SETS OF BUILDDilG PL.ANS & (1) SET ENERGY FORHS.H <br />~~COPY OF COlNlTRAcr Rll'Qm:RED. <br /> <br />PERKITS REOIW~<;TRD <br /> <br />v-BUILDING <br /> <br />$ <br /> <br />/;;;"'utJ. <br />/ <br /> <br />Valuation ot: 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 ot: Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFDiG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block <br /> <br />_Preme _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR EI..EVATIOIllS: <br /> <br />Fr. <br /> <br />IS PROJECT IN FLOOD ZOINlE ARE."'-? <br /> <br />\'l:S NO <br /> <br />~~~~~*~~~*~~**~**~~**~~~~~~~~**~**~******~ <br /> <br />BUILDER j I J /l <br /> <br />SignaturePU,U. <br /> <br /> <br />COllilTRACTOR SEctION <br /> <br />COHPAOOY uJ. fj .N f'J.''YI4 u.-../ G~t/-'. i::'. <br />State Cert. or Regist.!# aD ;: ~c.. ~ <br />City License Registration # ~/ <br />/ <br />**************************~~~~***~******** <br /> <br />SiroIature <br /> <br />CUlfPANY <br />State Cert. or Regist. # <br />City License Registration f <br />************************************~*~**~ <br /> <br />El.ECTRICIAN <br /> <br />COllfPANY <br />State Cert. or Regist. !# <br />City L,icense Registration lj <br />~~~~***~************~*****~~****~~***~**~* <br /> <br />PLtmBER <br /> <br />Signature <br /> <br />CO'!IPANY <br />State Cert. or Regist. f: <br />City License Registration i <br />****************************************** <br /> <br />KECHANICA.L <br /> <br />Signa ture <br /> <br />CO'!IPANY <br />State Cert. or Regist. !# <br />City License Registration , <br />***********************~****************** <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PEIU...-rT OFFICER. <br />