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<br />APPLICAnOW FOK PERllIT <br />CItY OF 2.Il;mI'RHIT.L~ <br />BUII.DIlIG DEPARnuJJIT <br /> <br />OWER'S NAItE Q L0 'D n:...W <br />OWREK'S ADDUSS l..f ~4 I l ~ ~ 5J-. <br /> <br />FIIOIIIE <br /> <br />JOB ADDRESS <br /> <br />~JY\ r" _ <br /> <br />LEGAL DESCRIPl'IOII: I.OI'(S) <br /> <br />~SUBDIVISIOIl <br /> <br />PAR.CEL I.D.' I'-I-~ -.:< I -66/0 - 0 ~;)...OO -CJO 3-.0 <br /> <br />liOn PROPOSED:_lIev Construction ~t.ion _Alt.eration _K.epair _Install <br /> <br />S. <br />- 19D. <br /> <br />_Hove <br /> <br />_>>e.Dlish <br /> <br />PROPOSED USE: <br /> <br />Single Fa.ily <br /> <br />_lI/F <br /> <br />_' of Unit:s <br /> <br />_lI/H <br /> <br />_ec-ercia1 <br /> <br />_Indust.. <br /> <br />_Stria. P001 <br /> <br />Ot:her <br /> <br />_Kest:aurant. 6: Hea1t:h ~t Approva1 <br /> <br />BUlLDIIIG SIZE: <br /> <br />x <br /> <br />~ Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />aJIttIERCIAL : <br /> <br />ATI'AaI (2) PLOI' PLAlIS 6: (2) SEI'S OF BUlLDIlIG PLAlIS 6: (1) SKI' ElIERGY FORtIS..... <br />ATI'AaI (3) SEI'S OF BUII..DllIG PIAJlIS 6: (1) SKI' ElIER.GY FORtIS..... <br />....OOpy OF OOllT.RAcr BIlQUIRED. <br /> <br />PERIIIl1S REOUESTED <br /> <br />~~LDING <br /> <br />$ <br /> <br />375.0-0 <br /> <br />Va1uation of Tot:a1 Construction <br /> <br />_ELEcnuCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.K.E.C. <br /> <br />---1fECIL\lIICAL <br /> <br />$ <br /> <br />Va1uation of lIechanica1 Inst:allation <br /> <br />_PLutmIIiG GAS ROOFIIIG <br /> <br />SPECIALTY <br /> <br />TYPE OF OONSTRUCI'IOIl: _Bloc1t _rr:.e _Stee1 <br /> <br />Other <br /> <br />nnSBED FLOOK ELEVATIOIiS: <br /> <br />Fr. <br /> <br />IS PROJECT IN FLOOD ZOO AREA? <br /> <br />YES 1i0 <br /> <br />............................................... <br /> <br />RIITU)F.R <br /> <br />aJlIDIACI'OK SECl'IOll <br /> <br />W!lPAIIY J:#H rfJa5()NR-I~l"Y}+ } nc... <br />.4 .....-:-:> J St:ate Cert. or Kegi.st. I . <br />~~ .[<,/)L){ JJ;' City License Kegistration' {./{/- <br />.............................................. <br /> <br />Signature <br /> <br />ELEcnuCIAli <br /> <br />W!lPAlIY <br />State Cert. or Kegist. , <br />City License Kegistration , <br />................................................. <br /> <br />Si.....Ature <br /> <br />PI.lIIIRF.R <br /> <br />aJIIPAlIY <br />State Cert. or Kegist. , <br />City License Kegistration , <br />............................................. <br /> <br />Signature <br /> <br />IlEalAllICAL <br /> <br />aJIIPAIIY <br />State Cert. or Kegist. I. <br />City License Kegistration . <br />............................................ . <br /> <br />Signature <br /> <br />. ~ <br /> <br />~ .~ <br /> <br />0T1IF.R COIIPAlIY <br />State Cert. or Kegist. I <br />Signature City License Registration . <br />................................................ <br /> <br />APPLICAnOIi APPROVED BY PERIII.T OFFICER. <br />