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<br />AI'PLlCi\TIO:1lI FOR I"lmal'T <br />CITY OF ZEI"Jll'lRIITLLS <br />llnrrlllJL~G DEI'A]lrr1rre~IT <br /> <br />OWER · S HAHE;:;; (() 1../- <br />I <br /> <br />OWNER' S ADDRESS ~<) if -3 I <br />s1'3'/ <br /> <br />JOB ADDRESS <br /> <br />;/rN'14. f <br /> <br />- <br />-rh. <br />If_ :sT <br /> <br />I (f-7 j, 5 r <br /> <br />SIC. <br /> <br />PlIO'1l.1E <br /> <br />21i IJ/, v'r( I-I-/L L5/ Fe- <br />'I ' <br />Z~/,fA f ~ !-IfLCs I ;::L <br /> <br />3' 3 sLjo <br /> <br />g 3 S-tjd <br /> <br />LEGAL DESCRIPTION: Lar(s) <br /> <br />Blf...oc.X <br /> <br />SUJBDH"ISION <br /> <br />PARCEL LD.I 1/2- c,;;.!- ()dl- 0;V-'000d50 <br /> <br />"'JORK PROPOSED:_lNJe:r.v CmlStruct 0l!l _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_I!foVle <br /> <br />_Demolish <br /> <br />PROPOSED USE: <br /> <br />Single FaGlil)' <br /> <br />_H/F <br /> <br />_, of lJ'lnIi ts <br /> <br />_M/H <br /> <br />_Coaaercial <br /> <br />_fudULSt. <br /> <br />_Swim. Pool <br /> <br />Other <br /> <br />_Res1taurant &ealt:h Deparbment Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />'- <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COHKERCIAL : <br /> <br />ATTACH (2) PLOT Pi ,\~S & (2) SEIS OF BUILDIlNIG J>L\~S & (1) Sf:T ENERGY FORMS. ** <br />ATTACH (3) SETS e BlJTIlllllilG PI.ANS & (1) SET EfN'E~~GY FORMS. i':::!l: <br />~::!:COI'Y OF CO~ITRAC !\lEQIDPJID. <br /> <br />PElRIDTS REQ1JJESTED <br /> <br />_BUILDING <br />V"ELECTRI CAL <br /> <br />$. <br /> <br />Valuation of Total Consltn.lction <br /> <br />c2d L) AL'fP Service <br /> <br />~ Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHANICAL <br /> <br />1) <br /> <br />Valu.ation of i!'lechanical Installation <br /> <br />_PLUMBING <br /> <br />Go'\'s <br /> <br />ROOFIJiiG <br /> <br />SPECL\LTY <br /> <br />TYPE OF CONSTRUCTION: _Bloc! . <br /> <br />_Fra!l:l!2 _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR .ELE:VATIm~S: <br /> <br />lP'l" . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />~~~~~~ ~**~*~~**~~*~~**~~~*~~:~**~~~~~*~~* <br /> <br />OOJ1lJTRACJrOR SF.CT'ION <br /> <br />BUILDER OOlHPANY <br />St:.a1te Cert.. or Regist.. #f: <br />Signature City License Regis~ration :# <br />~~~~~~ ~~~~~~~~.*~~~~~~~~~~~~~~~~~~~~~~~~~ <br /> <br />RI.ECTRICI;e iC'O'lWk"lrY fjei'f ~IJ C2A-~~OJtL-L ,flE~/cA L C-OJTNtte-T(}JZ <br />/ ! / 17 _ State C~rL or RegisL #< E~ 00/,;) 9/cJ <br />Sirolature /c>'t~~' (,/i.d-z~-f Ci.t.y License Registration I C2 7"6 <br />~~~~~~ .~~~~~~~~~~~~~~~~**~~~~~~~:~~~~~~~:* <br /> <br />Signature <br /> <br />a:m:pAn <br />State Cert. or Regist. # <br />City License Registration # <br />~t~~~~2~~.*~~~~~*~~.*~*..******~~~~~~t~~~~ <br /> <br />PIDIBER <br /> <br />MEClIANICAL CDl!fPANY <br />State Cer~. or Regist. ~ <br />Signature City License Registration ~ <br /> <br />~~~~&~ ~~~*~~~*~tt*~*~~~~~~~*~~~~~~~~~~~~~ <br /> <br />011IER CO'!'WA~"Y <br />State Cert. or Regist. ~ <br />Signature City License RcgistTation 1# <br /> <br />*~~*k1 ~~~*~*~~~~*~~*~~~*~*~~~t~~~~~~~~~~~ <br /> <br />. 1 J -<:~ ':~~::~:.; -,,' -;~',~ i <br />APPJ.ICATION APPROVED BY' <br /> <br />~ . - "Om{: :1 <br />Ll :"",~;, \ri;;;;__ <br />