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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIY.RIIII.LS <br />BUlLDTIiG DEPAR'IIfENT <br /> <br />OWNER' S MAKE <br /> <br />CL /h L7L <br />38018 <br />3801 B <br /> <br />;:a OUJf:/t. mrJ1..J <br />LAWAIJIJA LCJt:) p. <br />LAwJ'W1J14 ~oP. <br /> <br />PIlOSE % 782~2-Z-7{' <br /> <br />OWNER' S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />" U,.(J/ff'"4. #t a5/ rU4- <br />, <br /> <br />LEGAL DESCRIPl'IOlM: LOT(S) <br /> <br />BI..OCK <br /> <br />SUBDIVISION <br /> <br />PARCEL LD.' I~-;z.~ -.:2/ - 6 I~ (') -0000 0 ~ Cl2-~.O <br /> <br />WORK PROPOSED:~5ew Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_I!fove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />_KIF <br /> <br />_, of Units <br /> <br />*-K/H <br /> <br />_~rcial <br /> <br />_Indost. <br /> <br />_S~. Pool <br /> <br />Other <br /> <br />_Restaurant &: Hea1th >>epan:.ent Approval <br /> <br />BUILDING SIZE: S.:f X ZB . <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDEIiTIAL : <br />COItftERCIAL : <br /> <br />AtTACH (2) PLOI' PLAWS &: (2) SEI'S OF BUll.DIMG PLANS &: (1) SET ENERGY FORKS. u <br />ATI'AaJ (3) SEI'S OF BUII.DTIiG PLANS &: (1) SET ENERGY FORKS."'''' <br />......COpy OF CONTRACT KIlQ1lJIRED. <br /> <br />PEHI!IITS REOUESTED <br /> <br />V'" BUILDING <br />r ELECTRICAL <br />~ MECHANICAL <br />i/ PLUHBING <br /> <br />$ <br /> <br />~ ,J , eJO <br />7; <br /> <br />Valuation of Tot:a1 Construction <br /> <br />/6tJ <br /> <br />AtIP Serwice <br /> <br />_ .~ _~Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />I~o <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />KOOFDlG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Pralle _Steel <br /> <br />j)1tJ. #o~ <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIOBS: <br /> <br />FI' . <br /> <br />IS PROJECT DI FLOOD ZONE AREA? ~ <br />YES NO <br /> <br />..................................******.................................................................. <br /> <br />aJlIil'I'RACI'OR SECTION <br /> <br />BIJTUlER <br /> <br />~-~ <br /> <br />. <br /> <br />COI!tPANY Hill. J~~ ~ ~ <br /> <br />State Cert:. or Regist:. # <br />Cit::y License Registration , <br />........................*....**............~........................................................................ <br /> <br />Signat::ure <br /> <br />a~~ <br /> <br />ELECTRICIAB .~.. .~ COI!tPARY ~,; j.../. JOILAXh--J e:z.e01lf./'t.- <br />. '. :J<<~~tate Cert:. or Regist. , <br />Si.....<ure!".i"1UUl&- ~h~ ~City License Registration I 3s' <br />~ .. .......***...........***.*......................................................... <br /> <br />COI!tPARY AI /2$ BtJ ~ /k-,.,J <br />St:ate Cert. or Regist:. , <br />~ii:::1" Licem;;e Registl.'3Lion I /08 <br />.................................*........**........................................................*......... <br /> <br />1IEaWII~~~4~4- <br /> <br />PlHlBER ~ <br />Signature ';()i - # J . <br />, <br /> <br />Signature ~l}l-illS 1'~/)/t1-l' 4',4.:>.14<.-. <br /> <br />mlItPANY ~ I}lf M ~ ILl ~ /h..I';.. G;-/) ~ <br />State Cert. or Regist. I <br />Cit::y License Registration I <br />............................**..**....*................................................... <br /> <br />-- A-<- <br /> <br />7~ <br /> <br />O'T'IIRR COI!tPMY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />........................*.*........*..................................*..............*............ <br /> <br />APPLICATION APPROVED 'BY PERKIT OFFICER. <br /> <br />;;>-. <br />