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<br />APPLICATiON fUR PERllIT <br />CI1Y OF ZEPHIICIlI.LI..S <br />BUllDllIG DEPARllulIlI <br /> <br />OWNER I S IIAItE <br /> <br />C '7-- <br />i..-:- 1/ C',I2.. e "A/'{ <br />I I, '\. " <br /> <br />l (J 'r 0/ tJ <br />S' A/Y\ e, <br /> <br />1'1 <br /> <br />III ;' fire!?):; ~ L j/ ftIOIIE <br />'n <br />N (!Ii. L,n i.A/ <br /> <br />OWNER I S ADDRESS <br /> <br />S '1.. ~ 'c-. JC?i-f <br />r ( <br /> <br />/ <br /> <br />JOB ADDRBSS <br /> <br />LEGAL DESCRIPl'IOJI: I.OI'(S) <br /> <br />~SUBDIVISIOII <br /> <br />PARCEL LD.' <br />- <br /> <br />WORK PROPOSED:_1Iev Construction ----...Add.ition _Alteration _.Repair _lnst:all <br /> <br />S. <br />- J.gIl <br /> <br />_lIove <br /> <br />~e.olish <br /> <br />PROPOSED USE: <br /> <br />Single Fam].y <br /> <br />_n/F <br /> <br />_' of Ifnil:s <br /> <br />_niB <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Swbl. Pool <br /> <br />Ot:her <br /> <br />-.Jlesl:aur8nt & Rea1t:h Deparment Approva1 <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />~e Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />aJItIIERCIAL : <br /> <br />ATrAm (2) PI.OI' PLAIIS & (2) SEIS OF BUlIJJIIIG PUUlS & (1) SKI' ElIERGY fORtIS... <br />ATrAm (3) SEIS OF BUlIJJIIIG PLANS & (1) SKI' ElIERGY fORKS... <br />..ropy OF OOlI'IKACI 1UlQU1JUII). <br /> <br />PJI:RIIllS R.EOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Va1uaUon of Tot:aJ. Construction <br /> <br />--ELECl'RIGAL <br /> <br />AIIP Service <br /> <br />Florida PoIIer Corp. <br /> <br />W.R.E.C. <br /> <br />--1IECllAlUCAL <br /> <br />s <br /> <br />Valuation of nechanica1 lnst:allation <br /> <br />_PLUllBIRG GAS ROOFllIG <br /> <br />SPECIALTY <br /> <br />TYPE OF roNSTRUC'I'IOII: --..Block -Tu.e _Steel <br /> <br />Other <br /> <br />FIIIISBED FLOOR KLEVATlOllS: <br /> <br />FI' . <br /> <br />IS PROJECI' IN FLOOD ZOIlE AREA! <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />Blnl.DRR -f/~' / .. _ _ <br /> <br />. '~ <br />S1gnature:::-...::l:-..:,. '..' . <br /> <br />aJII'IRACIUIl SECI'IOR <br /> <br />(DIpAllY ,fI--<.f2{';;,~' ,//'/ {, 151 .I ~ /J^-./' .J l-l L (/ /L-t <br />J.r? I Sl:ate Cert. or Regist.' 1\.J. d o..s .Lf.~ I '-/ <br />{ .-:::- ~_--i &q City License Registration , 7..J <br />.......................................... <br /> <br />1t1.F.:CT'RTCIAR <br /> <br />alllPAIIY <br />State Cerl:. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />SiPIIAture <br /> <br />PUllBER <br /> <br />lDIPAlIY <br />State Cert. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />Signature <br /> <br />~IGAL <br /> <br />aJIIPAlIY <br />State Cert. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />Signature <br /> <br />01'IIItR <br /> <br />CUlPAlIY <br />Sl:ate Cert. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />Signature <br /> <br />APPLICAnOR APPROVED BY <br /> <br />PERIIIT OFFICER. <br />