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<br />APPLICATIO]lil fOR PERftIT <br />CITY OF Z,EPllTRBI US <br />BurILDUiG DEPARDIIl'Mr <br /> <br />OWNER"S NME ~~; J~ <br />OWNER'S ADDRE'SS38ot:::J~ ~~ <br /> <br />PHONE <br /> <br />.JOB ADDRESS <br /> <br />/( <br /> <br />LEGAL DESCRIPI'ION: IDr(~ii) <br /> <br />BLOCK <br /> <br />SUBDIVISIOINI <br /> <br />PARCEL I. D. t <br /> <br />WORK PROPOSED :_lNIew Construction <br /> <br />~ition _Alteration _Repair <br /> <br />_Install <br /> <br />_Sign <br /> <br />_!!love <br /> <br />_De-.oHsh <br /> <br />PROPOSED USE: <br /> <br />Single F~ily <br /> <br />_"IF <br /> <br />_, of urnits <br /> <br />_K/8 <br /> <br />_~rci3l <br /> <br />_Indust. <br /> <br />_Swt.. Pool <br /> <br />01:her <br /> <br />_Restaurant & Healt:h Depart.ent Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COPtIPtHRClAL : <br /> <br />A'lTACB (2) PLOI' PLANS & (2) SEI'S OF BUILDING PLAliS & (1) SKI' ENERGY fORKS... <br />AlTACII (3) SEI'S OF BUII.DUIG PLMS &: (1) SKI' ERIlRGY FORKS....... <br />..OOPT OF OOIfl'RAGI' RIlQtIIIRllD. <br /> <br />./' <br />_BUILDING <br /> <br />PIlmIlTS REOUESTED <br /> <br />$. ..3 d?rO . c)"1::> <br />, <br /> <br />ValuaUon of Total Construction <br /> <br />~LECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />----1If;CHANlCAL <br /> <br />$ <br /> <br />VaLuation of Mechanical Installation <br /> <br />~PLUK8ING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF OONSTRUCTION: _Block _Fr~ _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIOBS: <br /> <br />FI' _ <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />................................................ <br /> <br />BUILDER <br /> <br />J;~ <br /> <br />~ ~An SECI'IOIi <br /> <br />'-- 4 St:ate Cert. or Regist. , <br />CH:y License Registration , ... ~ gb <br />.. .~~:................................... <br /> <br />Signature <br /> <br />ELECTRICIAN <br /> <br />COIIPMY <br />St:ate Cert:. or Regis1:. , <br />City License Registration t <br />................................................................ <br /> <br />Silmature <br /> <br />PLUllBER <br /> <br />COIIPMY <br />State Vert. or Regist. t <br />City License Registration t <br />.................................................................... <br /> <br />Signature <br /> <br />KECllANlCAL <br /> <br />lUIPAfi <br />State Cert:. or Regis1:. , <br />City License Registration , <br />................................................ <br /> <br />Signature <br /> <br />OTHER <br /> <br />OOIrIPARY <br />State Vert. or Regist. t <br />Cil:y License Registration t <br />............................................................................ <br /> <br />Signature <br /> <br />APPLICATION API'ROYED BY J1d >f/ ~ <br /> <br />PEIUllT OFFICER. <br />