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<br />t,: <br />_'S - LOU/5 i+o/rJ h-+ <br />0WlIHR' S ADDRlfSS ~} J V .' 1 04 <br /> <br />APPLICATIOII FUR PERllIT <br />CITY OF l.m'HIKH IT. IS <br />BUllJ)DIG DEPAImUJ'Bl' <br /> <br />PIIOIIE <br /> <br />~S~rLeT <br /> <br />7&- <br /> <br />99~ <br /> <br />JOB ADDRESS <br /> <br />SUBDIVlSIOR ---------.. <br /> <br />LEGAL DESCRIPl'IOR: IDI'(S) <br /> <br />JII'.O(;X <br /> <br />PARCEL I.D.' _ <br />WORK PROPOSED:_lIev Construction ~ition _Alteration _Repair _Inst:all <br /> <br />S. <br />- 19I1 <br /> <br />_lIove <br /> <br />_De80lish <br /> <br />PROPOSED USE: <br /> <br />\ A'~e F8llily <br /> <br />_fl/F <br /> <br />_' of Units <br /> <br />_fl/H <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_S~. Pool <br /> <br />Other <br /> <br />_Rest:aurant 5: Health Deparblen.t Approval <br /> <br />BUILDING SIZE: ~. dl~O <br /> <br />~ID~ A'lTAaI (2) PIJJI' PIAIIS 5: (2) SEIS OF BUD.DDIG PIAIIS 5: (1) SET ElIERGY FORtIS....... <br />mHIIERCIAL: ATrAaI (3) SEIS OF BUD.DDIG PIAIIS 5: (I) SET ElIERGY FURIIS....... <br />......OOpy OF OORTHACf JUIQUIRIJD. <br /> <br />~e Feet. <br /> <br />r3t01/ <br /> <br />Height <br /> <br />~/7D002- <br /> <br />Pl!:RKTTS KEOUESTED <br /> <br />~LDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECl'RICAL <br /> <br />AIIP Service <br /> <br />Florida PoIIer Corp. <br /> <br />W.R.E.C. <br /> <br />-.JtEmAlfICAL <br /> <br />$. <br /> <br />Valuation of flechani.ca1 Inst:allation <br /> <br />_PLuttBUfG GAS ROOFDIG <br /> <br />SPECIALTY <br /> <br />TYPE OF OONSTRUCTIOR: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FIIIISIIED FLOOR .ELEVATIOIIS: <br /> <br />FI' . <br /> <br />IS P.RO.JECI' IIi FLOOD :mIlE AREA? <br /> <br />YES NO <br /> <br />.......................................................................................................................... <br /> <br />Rml.DER <br /> <br />lDnRAClW ~ \ <br />OO!IPAIIY . \rS A )UV>l1 l\UV~ (~qvd~ R,~~ J <br />~ '-~ State Cert. or Ilegist.' e-Bt:OillB.o7'j <br />City License Registration' ,..:,7 ~Cf <br />.............................................................................................. <br /> <br />Signature <br /> <br />RI.F.CTRTCIAIJ <br /> <br />COIIPAIIY <br />St:ate Cert. or Regist. . <br />City License Registration . <br />.................................................................................. <br /> <br />SilmlAture <br /> <br />PI.DIRF.R <br /> <br />c::DIPAlIY <br />St:ate Cert. or Regist. . <br />City License Registration . <br />........................................................................................................ <br /> <br />Signature <br /> <br />IlECBARICAL <br /> <br />COIIPAIIY <br />St:ate Cerl:. or Regist. . <br />City License Registration . <br />.............................................................................................. <br /> <br />Signature <br /> <br />0T1IF.R <br /> <br />c:DIPARY <br />St:ate Cerl:. or Regisl:. . <br />City License Registration . <br />.............................................................................................. <br /> <br />Signature <br /> <br />APPLIc&TIOR APl'IIOVIlD IIY 11<7/2< -"Ad- _-;// f/k:Il-,r <br /> <br />PERIIIT OFFICER. <br />