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<br />APPLICA'ITOR FOR PF.P.KIT <br />CJ'IY OF' ZEPllYRBIu..s <br />BIITIJUIIG DEPARIHRNT <br /> <br />OWNER'S ADDRESS <br /> <br />f/..v. W- +-Uc.t;~ <br />u,(p ('3 <br /> <br />PIIONE <br /> <br />CNNER'S RAKE <br /> <br />- <br /> <br />"'<II.. <br /> <br />rn. t1C11t.. <br /> <br />I)",. <br /> <br />JOB ADDRESS ("5 tJ hv'\- <br /> <br />I..EGAL DESCRIPTION: LOI'(S) <br /> <br />.BLOC'IL-SUBDIVISIOR <br /> <br />'" <br /> <br />Se III '" "\ <::? r.l [{ 5 <br /> <br />PARCEL I. D.' <br /> <br />WORK PROPOSED:_Rev Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_l!Iove <br /> <br />__De.olish <br /> <br />PROPOSED USE: <br /> <br />Single Faail)'" <br /> <br />_"IF <br /> <br />_' of Units <br />-ASwiJI. Pool <br /> <br />_R/H <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />Ot:her <br /> <br />_Rest:aurant &- Bea1t:h Departaent Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL : <br />COItItERCIAL : <br /> <br />ATI'ACH (2) PLOI' PLAliS &- (2) SEI'S OF BUILDDfG PLAIIS &- (1) SEl' ENERGY FORKS. ** <br />ATTACH (3) SEI'S OF BUILDIJIG PIARS &: (1) SF.T ENERGY FORKS.** <br />**OOPY OF OON'l"RAct JU!Q1BIRIlD. <br /> <br />PERKITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ I c.{~ <br /> <br />Valuation of Total Construction <br /> <br />_ELECI'RICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_KECllAlUCAL <br /> <br />$ <br /> <br />___Valuation .of Mechanical Installation <br /> <br />_PLUKBING GAS ROOFDiG <br /> <br />SPECIALTY <br /> <br />TYPE OF OONSTRUCTIOR: _Block _FraIIe _Steel <br /> <br />Ot:her <br /> <br />FHIISBED FLOOR ELEVATIORS: <br /> <br />FT. <br /> <br />IS PKOJEC'l" IN FLOOD zmm AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />COJIil'I'RACIOR SECTION <br /> <br />BVPJlER -!J COIIPAIO' ~-Y-<<.- P.el.., +-~ <br />(J \ St:ate CerL or Regist.' Qt?<.. O..t.:$" 'S\{.J-- <br />Signature ~ ~ City I.ic~se Registration' .1l) <br />**********************x.****************** ., . . <br /> <br />EUCTRIClf'\ / COIIP'- 11 ~ T;, u...-"".!...../ 8C--C3-~ <br />I __ / ~ St:a1:e Cert:. or Regist:. , EQr!J I~(J '7 sPe..~ <br />Silm:lture VQ,/\A..I\/V1/1 ~ f::;;.". A";I ,/' City License Registration I t;) '7 <br />* *********************~*************** <br />L-- <br /> <br />aJltPOY: <br />State Cert:. or Regist. , <br />City License Registration I <br />**************~******~******************** <br /> <br />PLUKBER <br /> <br />Signature <br /> <br />Signature <br /> <br />cmiPANY <br />St:ate Gert:. or Regist:. I <br />City License Registration , <br />********~*w***********~******************* <br /> <br />~pt <br /> <br />KECllAlUCAL <br /> <br />0T1IF.R ~ ~ aJ!fPlmy ~,--I-<- <br /> <br />) ~-tJ. St:ate Cer:.':. or Regi . f . / <br />Signature .;: j() City l.icense Registration <br />*** *****~**************************** <br /> <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />