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<br />APPLICATIOIi FOR PERllIT <br />CITY OF ZIl;puIKnn.Lc; <br />BUII.DI.liG DEPARIIIElIT <br /> <br />OWNER · S lIlAKE <br /> <br />(Vl C< R ~ fL-.{!f! 15 r he !c/V~ PROBE 7 B l? ,- :/ 0 ~ S-- <br />$-Aq II ?-O ~ 5'1/ <br />s;'A--VY? e <br /> <br />0WlIItR' S ADDRIrSS <br /> <br />JOB ADDRESS <br /> <br />I.EGAL DESCRIPl'IOII: I.OI(S) <br /> <br />JU:.OCIt: <br /> <br />SUBDIVISIOII <br /> <br />PARCEL LB.' / I -~ - ::1-/- h t? / /2- 0 '7 '/ 00- t!J OS-O <br /> <br />WORK PROPOSED:_lIev Construction _Addition _Alteration _.Repair _Install <br /> <br />S. <br />- J.gIl <br /> <br />~ve <br /> <br />_De.olish <br /> <br />PROPOSED USE: <br /> <br />Single F~i1y <br /> <br />_fl/F <br /> <br />_, of Units <br /> <br />_"/H <br /> <br />_ec-ercia1 <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />Other <br /> <br />_Restaurant &: Hea1th Depar~t Approva1 <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />~e Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />aJIIKERCIAL : <br /> <br />A1TAaI (2) PI.OI' PLAIIS &: (2) SEIS OF BUlLDDfG PLAIIS &: (1) SET ENERGY FORlf.S."'''' <br />ATrAaI (3) SEI'S OF BUllDllIG I'I.AliS &: (1) SET .EIIER.GY FORlf.S....... <br />......Wpy OF WlI'IRAct KIlQUIRIID. <br /> <br />PDDII'lS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Va1uation of Tota1 Construction <br /> <br />.--JtEmARICAL <br /> <br />s <br /> <br />AIIP Service Florida Power Corp. <br />oV <br />7- S ifz) , Va1uation of "ecbanica1 Installation <br /> <br />W.R.E.C. <br /> <br />_ELECTIUCAL <br /> <br />_PLmtBING GAS ROOFIIIG <br /> <br />SPECIALTY <br /> <br />TYPE OF WNSTRUCl'IOII: _Block _F~ _Steel <br /> <br />Other <br /> <br />FIIIISHED' FLOOR ELEVATIOIIS: <br /> <br />FT. <br /> <br />IS PRO.JECI' III FLOOD ZOIlE AREA'! <br /> <br />YES NO <br /> <br />.............................................................................................................................. <br /> <br />aJlI'I'KACIOR SECl'IOR <br /> <br />BnTT .DO <br /> <br />Signature <br /> <br />aJ!IPAliY <br />State Gert. or Regist. , <br />City License Registration . <br />.............................................................................................................................. <br /> <br />S. <br /> <br /> <br />aJ!IPAIIY )j:: /"c <:.. t (fJ J d-S.s t:/ e c t/ . e- <br />State Gert. or Regist. . Elf? do ,; r::..--,/ 7 <br />City License Registration' / <;- 'i' <br />............................................................................................................... ' / <br /> <br />PU-.RD <br /> <br />Signature <br /> <br />aJ!IPARY <br />State Cert. or Regist. , <br />City License Registration . <br />.............................................................................................................................. <br /> <br />Signature <br /> <br /> <br />~ /7i- <br />aJ!IPAIIY A f' IU S.9-....-:;- L-~.r <br />State Gertf. or Regis~( . t!) 6).:> C/ / ~ <br />City License Registration . 7/ <br />........................................................................................................................... <br /> <br />IIECIIAlIICAL <br /> <br />0TRll:R <br /> <br />Signature <br /> <br />(DIpARY <br />State Gert. or Regist. t <br />City License Registration . <br />.............................................................................................................................. <br /> <br />APPLICATIOIl API'BOVIlD BY '11,1 At l' ~ ~ o.A/11.:Y <br /> <br />PEHIiIT OFFICER.. <br />