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<br />APPLICA'rI05 FOR PERHIT <br />CITY OF ZEPIIYIbllLLS <br />BUII.DIBG DEPARI1!IEXT <br /> <br />OWNER · S MAKE <br /> <br />j() A I( <br />OWNER' S ADDRESS '/ jJ If cJ . S /' H <br />JOB ADDRESS :2 f IF J-/ Y tFJ H) 2 L :5 <br /> <br />-rO 15 /? .-9 ;1':) fiN <br />~T <br /> <br />PROBE <br /> <br />7~-2 ~ t;? I:;? <br /> <br />FL <br /> <br />\ <br />~5-3_s ~ /, <br /> <br />LEGAL DESCRIP'l'ION: UJI'(S) <br /> <br />,_BJ.OCl{ <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D . , ) 1;/ - ,;;j ~ --,,;;1 <br /> <br />{)CJICJ <br /> <br />t'~oo <br /> <br />(21--S/J <br /> <br />WORK PROPOSED:_5ev Construction ~tion __Alteration _Repair _Inst:.all <br /> <br /> S. --1fove _DetaOlish <br /> - 19I1 <br />PROPOSED USE: Single F3IIily _'tlF _, of Units _K/H <br /> _<=<-ercial _Indust. .1L.Swia. Pool Other <br /> _Rest:.aurant 5: Health ~t Approval <br /> <br />BUILDIRG SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL : <br />COttKERCIAL : <br /> <br />A'l'TACII (2) PLOl' P.l.A5S 5: (2) SEI'S OF BUILDING PI..OS 5: (1) SEt' RNERGY FORKS. ** <br />ATTACH (3) SEI'S OF B1JIIJ)DG P.l.A5S 5: (1) SEt' ENERGY FORMS. ** <br />**COPT OF COwrBACT REQIlJIKIlD. <br /> <br />PEmUTS REQUESTED <br /> <br />LBUILDTNG <br />-t-ELECTRICAL <br />_KECllANICAL <br />~PLmmING <br /> <br />$ ,/ g, 8"tJ 0 t'1 () Valuation of Total Construction <br />AKP Service $_Fl0rida Power Corp. <br /> <br />W.R.E.C. <br /> <br />s <br /> <br />Valuat:ior.. of Kecbanical Inst:allat:ion <br /> <br />__GAS <br /> <br />RGOFDJG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _~ _Steel <br /> <br />Ot:her <br /> <br />FHfISHED FLOOR ELEVATIONS: <br /> <br />FI' . <br /> <br />IS PKOJECT Di FLOOD ZONE AREA? <br /> <br />YE.':; NO <br /> <br />t********************t*~****************** <br /> <br />COJIIII'RACI'OR SECTION <br /> <br />BUII.DER 0:--- <DIPANY /? q r7.s 'f:t () 2- ( CJ . <br />/1' ,_;/ v/ / S1:at:e Cert:. or Regist:. I !3rP 110 2/9 g &}'7 <br />Signature ~/7~ ~ City License Registrat:ion I J~ <br />****************************************** ' <br /> <br />F.T.F.C'TRTCIAN1 i <DIPAI!iY K/Cktt IU) (;2 A-tJ 0,4 t L fftE C T~lC~ C LdiJTI2ft<.T&7( <br />j / iJjJ ~~! S1:ate Cert. or Regist. I <br />SiPn:lture p\---,t{.fL6-~~1 ' (.A'ttAc#6" "'/ City License Registration t Jt/{) <br />****************************************** <br /> <br />Signature <br /> <br />;;--: OOIWMY p~ 7" ~ <br />ad.. ~ U. State Cert:. or Regist. , <br />.(17 ~. City ~;,icense Registration <br />****************************************** <br /> <br />~~L etl- <br />fF) I? d cf !:I tJ' R".o/ 7 <br />I )L~ <br />. <br /> <br />PLOtIBER <br /> <br />Signature <br /> <br />CUltPMY <br />S1:at:e Cert. or Regist. I <br />ff " h ~ City License Regist:ratj.on I <br />*********~*~****************************** <br /> <br />KEalANICAL <br /> <br />0'T1I"F.R fL' ~~ <DIPALw-Bz:-n/./'f.&71:JA/ ALq(?J/lIVP? <br />S1:at(' Cerl:. or Regu;t. I <br />Signature City Lic~e Registrati.on # '2 ,- <br />***** *~~***~********v*************~*** <br /> <br />APPLICAnOR APPROVED BY PERKIT OFFICER. <br /> <br />. , <br />