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<br />APM.,ICAl'1011i fOR PERftIT <br />CUT OF ZEPIIIRIII Lts <br />BUIW I IiG DEPARJltEIIT <br /> <br />LE(,,~L DIl'SCRIPI'lON: Wr(S) <br /> <br />6il,. <br />S, L/ <br /> <br />1 - / POORE 7 J> lj - ? '7 ~ .y <br />~ 6; rt l,0 (j d cl 1 /\ I 7 I ~ . '//n ;: / c <br />/ <br />17 v c:: Z r' jJ ~'//.c ;;',' /0' , / / <br />/ / <br /> <br />OWNER · S NAHE ,..s f: IT! I- A' ~ <br />OWNER' S ADDRESS ..<./ d J / <br />.JOB ADDRESS () 9" CJ d CJ <br /> <br />/? € <br />C cJ ~ "1 P <br />, <br /> <br />BI~ / <br /> <br />SUBDIVISIOR:Z {i p h '//6 <br />, . <br /> <br />J-/e,'o47c <br />,/ " <br /> <br />PARCEL 1.1).' / ~ -.) t- ~ / <br /> <br />(I) ~ ~ /7 -- 0 c9 / 6J I) - cJ _ ~'?/ fJ <br /> <br />WORK PRorosm:_lIev Construction ~ddit ion _Alteration ---Repair _Install <br /> <br />_Sign <br /> <br />-'fove <br /> <br />_De-.oHsh <br /> <br />PROPOSED USE: )c Single F8IIily <br /> <br />_It/F <br /> <br />_' of Units <br /> <br />_It I 8 <br /> <br />_ec-ercial <br /> <br />_lndust. <br /> <br />_Swu.. Pool <br /> <br />Other <br /> <br />___estaurant 5- Health Depart.....t Approval <br /> <br />RUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />conttERCIAL : <br /> <br />ATtACH (2) PLot PLAIIS " (2) SEIS OF BUUDIRG PLAIIS " (1) SKI' ERERGY FORtIS. u <br />ATTACH (3) SItI'S OF BUILDING PLANS" (1) SKI' EIIERGY FORKS....... <br />......COPT OF CONTRACTRIIQUIRllD. <br /> <br />PEIUIllS REOUESTED <br /> <br />_RUIUHNG <br /> <br />$ <-~ CJ !f>{) ~ <br /> <br />Valuation of Total Coustnlction <br /> <br />_ELECTRICAL <br /> <br />Aftp Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />--"R('lIANICAL <br /> <br />$ <br /> <br />Valuat ion of Kechanica.l Installation <br /> <br />~LUHBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TIPE OF CONSTRuc:nOIll: _Block _Fr~ _St.eel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS FROJRCT IN FLOOD mRR AREA? <br /> <br />YES NO <br /> <br />.............................................................................................................................. <br /> <br />aJIIIfRACIUR SE(."I'ION <br /> <br />" L7 -/' <br />Signaturei/r-- A' <br />/7 <br /> <br />WllPAJlfY Td d ~ / I.. S' h--1 , '.,J A <br />_____./'z'. <? State Cert. or Regist.' I <br />~ City License Registration <br />.~.................................................................................................................. <br /> <br />C dr-...i /~ <br />{IS <br /> <br />BUILDER <br /> <br /> <br />OOPIPAIIII' ~~r c ~G3 <br />State Cert: or Regist. , <br />City l.icense Registration' 1571 <br />................................................................................ <br /> <br />Elc:?cf <br /> <br />PLutlBER <br /> <br />aJ!tpJ\Ny <br />State Ce["t. or Regist. , <br />City License Registration , <br />........................................................................................................ <br /> <br />Signature <br /> <br />ItECHAlUCAL <br /> <br />OOfIPAIIIY <br />State Cert. 0[" Regist. , <br />CUll' License Registration , <br />............................................................................................................................ <br /> <br />Signature <br /> <br />OlIIRR <br /> <br />CUPlPAIIY <br />Sta~e Vert. or Regist. , <br />City License Registration t <br />............................................................................................................ <br /> <br />Signature <br /> <br />APPLICATION APPROVIfD BI <br /> <br />"I/d.AA ,..~ 4" J,-A.-J <br /> <br />PEMIT OFFICER. <br />