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<br />APPLICAn()1I fOR PERllIT <br />CITYOFZIl:JIIIYJUULLS <br />BlJIU)lJfG DEPAR1IIEIIT <br /> <br />JOB ADD.RESS <br /> <br />/ft;v /.'1 fo,{, TO L Iff Nb<! <br />:5',<\/ 07VL CvV <br />ArUo,Z;( / <br /> <br />PIIOlIE <br /> <br />~~ 783/ <br /> <br />OWNER'S RAIlE <br /> <br />OVlIER'S ADDRESS <br /> <br />BUILDING SIZE: <br /> <br />_Restaurant: 6: Hea1th Deparment: Approval. <br />'7 X (0 , 2fU <br /> <br />~e Feet:, <br /> <br />Height <br /> <br />.RESIDENTIAL: <br />mtIIIERCIAL : <br /> <br />ATrAat (2) PI.OI' PIAIIS 6: (2) SEIS OF BUIl.DDIG PLAIIS 6: (1) SEI' ENERGY PORtIS."'''' <br />ATI'AaI (3) SEIS OF BUII.DIIIG PIAIIS 6: (1) SEI' EIIERGY JIORIIS."'''' <br />......OOPl' OF OOIn'.RAcr DQUIllIID. <br /> <br />PIlmITlS KEOOESTED <br /> <br />---..BUILDING <br /> <br />$ <br /> <br />Va1uat:ioo of Tot:a1 Const:ruct:ion <br /> <br />F.I.RCl'RICAI. <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-.JIEGllANICAI. <br /> <br />$. <br /> <br />Va1uat:ioo of lIechanicaJ. Inst:a11at:ion <br /> <br />_PLuttBING GAS ROOFDIG <br /> <br />SPECIALTY <br /> <br />TYPE OF mNSTRUCl'IOIi: _Bloclt _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVAUOIIIS: <br /> <br />n. <br /> <br />IS PIlOJEcr III FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />........................................................................................................................ <br /> <br />aJIII'RACItBl SECl'ION <br /> <br />BIJTT.nm <br /> <br />~I(~~ <br /> <br />C () AI Ci '?}ff-C- <br />St:at:e Cert:. or Regist:. # <br />Cit:y License Regist:ratioo # <br />...................................................................................................................... <br /> <br />CUlPAIIY <br /> <br />/!LU 11>'~/1 <br />~71 <br /> <br />Signat:ure <br /> <br />RT.F.C'IRICIAN CUlPArIY <br />St:at:e Cert:. or Regist:. # <br />Sitm:.llt:ure Cit:.)" License Regist:rat:ioo # <br />........................................................................................................................ <br /> <br />PLlINRRR aJIIPAlIY <br />St:ate Cert:. or Regist:. # <br />Signat:ure Cit:.)" License Regist:rat:ioo . <br />............................................................................................................................ <br /> <br />1lEalAllICAI. CUlPABlY <br />St:ate Cert. or Regist:. # <br />Signat:ure Ci1:y License Regist:rat:ioo . <br />...................................................................................................................... <br />I <br /> <br />0T1IRR aJIIPAlIY <br />St:ate Cert:. or Regist:. I <br />Sigoat:ure Cit:.)" License Regist:rat:ioo # <br />................................................................................................................ <br /> <br />APPLICAUOR APPROVED BY ..manr OFFICER. <br />