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<br />I . <br />APPLlCAnOll FOR PERlUT <br />CITY OF umtIKIlll.Ls <br />BUII.DllIG DEPARJIIEIIT <br /> <br />OIIIIIlIl'S _ Q <br /> <br />Un; ~ <br /> <br />PIIOlIE <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPl'IOII: LOI'(S) <br /> <br />~SUBDIVISIOR <br /> <br />PARCEL 1.D.' <br />-' <br /> <br />WORK PROPOSED:_1Iew Construction -.JWdi.tion _Alteration __epair _Install <br /> <br />S. <br />- 19B. <br /> <br />~ve <br /> <br />_DeIIolish <br /> <br />PROPOSED USE: <br /> <br />Single F_ily <br /> <br />_H/F <br /> <br />_' of Units <br /> <br />_H/B <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />Other <br /> <br />~t:aurant &: Bea1th Deparmenl: Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />~e Feet. <br /> <br />Beight <br /> <br />RESIDENTIAL: <br />COIf.If.ERCIAL : <br /> <br />ATrACII (2) PUJI' PLAlIS &: (2) SKIS OF BUII.DIRG PLAIIS &: (1) SKI' EllERGY FORtIS..... <br />ATrACII (3) SKIS OF BUII.DIIIG PLAIIS &: (1) SKI' IllIERGY FORIIS..... <br />....ropy OF roR'IRACl 1UlQUI.RIID. <br /> <br />PII'RJI11S KEOUESTED <br /> <br />_BUILDING <br /> <br />$. <br /> <br />Valuation of Total Construction <br /> <br />F.T.F.Cl"RlGAL <br /> <br />AIf.P Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />.-If.ECllARlGAL <br /> <br />$. <br /> <br />ValuaHon of Hecbanica1 Inst:allal:ion <br /> <br />~mmING GAS KOOFIIIG <br /> <br />SPECIALTY <br /> <br />TYPE OF OONSTRUCl'ION: --..Block ---Yu.e _Steel <br /> <br />Other <br /> <br />FIIIISHED FLOOR ELEVAnOllS: <br /> <br />n. <br /> <br />IS PROJECl IN FLOOD ZORE AREAT <br /> <br />YES NO <br /> <br />................................................................................ <br /> <br />aJIIIRACIOR SECI'10R <br /> <br />lDIPMY <br />State Cert. or Regist. , <br />City License Registration , <br />.......................................................................... <br /> <br />BUIIJ)F.R <br /> <br />Signature <br /> <br />ItIRCrll1CIA11 CDIPAIIr . __ G.. ~ <br />'=::4~~~. State ~. or &is! ' · EIt.OM'S" <br />S. ~ en.. L1ceose _is .. 100' Y / <br />~ ...... ..................................................... ' <br /> <br />, <br /> <br />PIJINRF.R amPMY <br />St:ate Cert. or Regist. , <br />Signature City License Registration , <br />............................................................................. <br /> <br />IIECIIAlIlCAL amPAIIY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />.......................................................................... <br /> <br />onllm COIPMY <br />Stal:e Cerl:. or Regisl:. , <br />Signature City License Registration , <br />................................................................... <br /> <br />APPLICAnOR APPROVED BY PERllIT OFFICER. <br />