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<br />APPLICATIOR FOR PERKIT <br />CIlYOFZEPIIYRIIIU..S <br />BMIJUlIiG DEPAImIEIT <br /> <br />OWER'S fWIE j)() # 1tL--~ <br />OWlIER'S ADDRESS , ? 9 J>cj I <br /> <br />f5 MS/-t <br />~ Zlt /li/~ <br /> <br />PROD 7 t!:? ~ J 9' CJ 7' <br />- <br /> <br />JOB ADDRESS <br /> <br />S"R r1 € <br /> <br />LEGAL DESCRIPl'IOlI: IDI'(S) <br /> <br />JlI.OCX <br /> <br />SUBDIVISIOII <br /> <br />PARCEL I.D.' <br />IlORK PtIDPOSFJ):_!llev Construction ~tion _Mt.eration _Repair _Install <br /> <br />S. <br />- 19D. <br /> <br />_!!love <br /> <br />_ne.olish <br /> <br />PROPOSED USE: A'ingle F~ily <br /> <br />_KIF <br /> <br />_, of Units <br /> <br />_KID <br /> <br />_<=<-ercial <br /> <br />_Indust. <br /> <br />_Stria. P001 <br /> <br />Other <br /> <br />BUILDIRG SIZE: <br /> <br />_K.est:aurant &- Hea1th Deparbent Approva1 <br />/2 X jt}, Square Feet. o?2f/ <br />. <br /> <br />ef> rp ~ t Height <br /> <br />RESIDENTIAL: <br />aJttIIER.CIAL : <br /> <br />A'ITAaI (2) PLOJ' PIAIIS &- (2) SEI'S OF BUILDDIG PIAIIS &- (1) SEt EllERGY FORKS. ** <br />ATI'ACB (3) SILTS OF BUILDDiG PLUS &- (1) SEt E5RRGY FORKS. ** <br />**OOPl' OF CONI'RACT REQIDlUlD. <br /> <br />V;UILDIIiG <br />~CAL <br /> <br />PERlPlITS REQUESTED <br /> <br />$ <br /> <br />.J "lOt). 00 <br /> <br />Va1uation of Tot:a1 Construction <br /> <br />A!IP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_KEaWUCAL <br /> <br />$ <br /> <br />Va1uation of tlechanica1 Inst:allation <br /> <br />_PLlDtBIIiG GAS ROOFDIG <br /> <br />SPECIALTY <br /> <br />TYPE OF OONSmUCTIOII: _Block _Fra.e _Steel <br /> <br />Other <br /> <br />FIWISIIED FLOOR KLEVATIOIiS: <br /> <br />FI' . <br /> <br />IS PROJECT IIi FLOOD ZOIlE AREA'! <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />COIII'KACIOR SEC'I'IOR <br /> <br />BmI.DF.R <br /> <br />~~L-j <br /> <br />v <br /> <br />/Jc ~/Z /) L t;f fl1 . <br /> <br />State Cert. or Regist.' c.:/2 Cb .j ~b F 0 <br />City License Registration , ./ 6!:J <br />****************************************** <br /> <br />COIPANY <br /> <br />Signature <br /> <br />=CID~ COIPMY ~ ~ <br />: /J .~ -;;C /) S~t:e <<:ert. or ~gist. .' t=.. )I? <br />_-=--~ _ C/ / /~~ C1ty L1cense Reg1strat:1on , <br />{ ***~************************************* <br /> <br />PUllBER <br /> <br />COIPABY <br />Stat:e Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />KECBAllICAL <br /> <br />COIPMY <br />State Cert. or Regist. . <br />Cit:y License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />0T1IF.R <br /> <br />COIPARY <br />St:ate Cert:. or Regist. t <br />City License Registration , <br />****************************************** <br /> <br />~".~,.~. .,. CER. <br />, ", .. ~ <br /> <br />I.J "~"-...,. , , '. i,' '. i" <br />j u- . ... ;, -'. 'i <br />s <br /> <br />S ignat:ore <br /> <br />APPLICAmM AP'ftojy~\~., <br /> <br />-', ...., t ,- <br />