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<br />APPL,ICATIo.lM FOR FERftIT <br />CITY o.F ZHPIffRIIILtS <br />BUIlDI WG DEPARJnmfT <br /> <br />~'C.t."'\~D D\~~~(LC <br /> <br />OWNER' S ADDRESS ''3l ~ s cL <br />(J I ;..{'Tre R.sl <br /> <br />OWNER · S NAttH <br /> <br />PHONE 7~~ -~bl-~ <br /> <br />C~S <br />f1~ 1+ ,0 <br /> <br />/)~ <br /> <br />JOB ADDRESS <br /> <br />LEGAL D&SGRIPrION: WI(S) <br /> <br />BLOCK <br /> <br />SUBDIVISIOI1 <br /> <br />PARCEL I. D. f <br /> <br />fer ~~ <br /> <br />::2-( <br /> <br />~ <br /> <br />() O~Oo <br /> <br />0000 <br /> <br />NORK PROPOSIID:_Jlew Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_lIIove <br /> <br />_De-.lish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />_"'F <br /> <br />_' of Units <br /> <br />_KID <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_Swill. Pool <br /> <br />o.ther <br /> <br />_Restaurant 5- Health Depar~t Approval / 0 <br />o I~ '1r' cAf(ro ~ <br />BUILDING SIZE: 1;2 X?-O, ~~ V ~ 1'1 Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />cottnERGJAL : <br /> <br />ATTACH (2) nor PLANS 5- (2) SErS o.F BUILDING PUUiS 5- (1) SET ENERGY FORKS. U <br />ATTACH (3) SEI'S o.F BUIl.DUIG PLANS 5: (I) SET BERGY FORKS.** <br />**oopy o.F ooNTRACf RIl'QUIRIID. <br /> <br />PIllUIlTS .REQUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />7/ (]V- <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_KEGIlANICAL <br /> <br />$ <br /> <br />Valuation of Mechanica.! Inst:allation <br /> <br />~LUK8ING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF mNSTRUCTIo.N: _Block _Fralle _SLeel <br /> <br />o.ther <br /> <br />FlllfISRED FLOOR KLEVATIONS: <br /> <br />Fr. <br /> <br />IS PROJHCT IN FLOOD ZONE AREA? <br /> <br />YES NO. <br /> <br />****************************************** <br /> <br />BUIWER <br /> <br />-----c~~-~-~~__ ....... aJII'I'KACIOR SEC'ION <br /> <br />,~ ) OO!tPAJIIIY L - 13 If L ~ L t..- <br /> <br />, 2,-/3 ~ !fL.Ke(;t.; S~te ~ert. or R:gist. .' <br />, ----- --- .-- -- CI.Ly LIcense Regl.stratIon , ~ 7 <br />****************************************** <br /> <br />Signature <br /> <br />ELECTRICIAN WlPU"Mlf .p~ ~ <br />(} /) -;7/~/7 State Cert. or Regist:. , ell? <br />SilPllsture -;~j U / /' ~p1 f?- City License Regist:rat:iOll f 0/ <br /> <br />PLIWIBER~*tIa*"'''*''''*'''':=cI:*i7;;: Plwbl ^1 <br /> <br />State Cerl::. or Regist. , <br />SignaLure ' ~ City License Regist:ration f / ~0 <br />****************************************** <br /> <br />KEmANICAL <br /> <br />lUIPANY <br />State Cert. or Regist. , <br />Ci~y License Regist:rat:ion , <br />****************************************** <br /> <br />Signature <br /> <br />OlllER. <br /> <br />OO!tPMY <br />State <:ert. or Regist. , <br />Ci~y License Regist:ration , <br />*****************************************~ <br /> <br />Signature <br /> <br />Al'P'.lCATlOR APl'IlOVW BY J!d~ . J L/I.{.'4 L. <br /> <br />PERIIlT OFFICER. <br />