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<br />APPLICAnOti fOR PERllIT <br />CI'IY OF ZItnIIKH. l.Le;; <br />JWII.DIJIG DEPAImulBr <br /> <br />OWlIER'S RAIlE fn tQ 4 fir R <"J f) II )7h n (u C '( 1/ f {~ ; (~- P8DIIE <br />OWlIER'S ADDIU1SS i." ( l/ s- /.., \r A); Il-e;r-<:., Ii <br />JOB ADDIU1SS S /4 f11 F <br /> <br />LEGAL DESCRIPl'IOII: I.OI'{S) <br /> <br />~SOBDIYlSIOB () Ii /~' <br />, <br /> <br />\~ <br />C ' <br />~,. ("=' <br /> <br />PARCEL LD.' <br /> <br />WORK PKOPOSED:_1Iev Construction ---Addition ~teration ~ _Install <br /> <br />_Sip <br /> <br />--.JIove <br /> <br />_Deao1ish <br /> <br />PROPOSED USE: <br /> <br />Single FaUly <br /> <br />_KIF <br /> <br />_' of Units <br /> <br />_K/B <br /> <br />_ec-ercia1 <br /> <br />_Indust. <br /> <br />_S~. P001 <br /> <br />Otl1er <br /> <br />RpSt:aurant &- Bea1t:h Departaent Approval. <br /> <br />BUILDItiG SIZE: <br /> <br />x <br /> <br />~e Feet. <br /> <br />Beight <br /> <br />RESIDENTIAL: <br />aJItIIERCIAL : <br /> <br />AtTAaI (2) PIDI' PIAlIS &- (2) SEIS OF BUIl.DIJIG PUUlS &- (1) SEI' EllERGY FOlUIS... <br />AtTAaI (3) SEI'S OF JWII.DIJIG PIAJJS &- (1) SEI' EIIERGY IDBIIS..'" <br />."'OOPl'" OF mB'I'KACI JIIIQUIRIID. <br /> <br />PIr.RIIl'I'S REOIJR..e;;Tm <br /> <br />--.-BUILDIRG <br /> <br />$ erC;O <br /> <br />Va1uation of Tota1 Construction <br /> <br />-3LECJ'lUGAL <br />---.JIEaIAIiIGAL <br /> <br />AIIP Sexvice <br /> <br />F10rida Power Corp. <br /> <br />V.R.E.C. <br /> <br />$ <br /> <br />Va1uation of 1f.eclJani.ca1 Inst:al1ation <br /> <br />.-PUItBItiG GAS ROOFIIIG <br />TYPE OF WRST.RIJCI'IOII: --.-B1ock _~ _St:ee.1 <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FDlISBED FLOOR ELEVATIOIIS: <br /> <br />Fr. <br /> <br />IS P.RO.JECI' III FLOOD ZOO AREA? <br /> <br />YES RO <br /> <br />.................................................................................................... <br /> <br />Rml.DER <br /> <br />~CI'OR SECl'IOti <br /> <br />aBPAIIY 'At:" ;~=- (~'-~~ C~o~~~ <br />c~ A-' D /).. (": -t:' I}I) D St:ate Cert. or Regist. I <br />J?Z.c.-1' ~ V"LA;;-t..i?~---n"<1 City Liceose Registration , . CJ c:;- u <br />v .................................................................................................................. r- <br /> <br />Signature <br /> <br />Kl.F.crJUCIAli CDlPAIIY <br />St:at:e Cert. or Regist. f <br />Si .....ture City Liceose Registration , <br />............................................................................................................ <br /> <br />PlDIRRR aJIIPAIIY <br />St:at:e Cert. or Regist. f <br />Sigoature City License Registration , <br />...................................................................................................................... <br /> <br />III!'.aIARTCAl. aJIIPAIIY <br />State Cert. or Regist. , <br />Sigoat:ure City License Registration , <br />................................................................................................................ <br /> <br />OTIID CDlPAIIY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />............................................................................................................ <br /> <br />APPLICAnOti M.l'BUY1W BY PERIIIT OFFICER. <br />