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<br />APPLlCAnOIl fUR PERllIT <br />GIn OF ~IKIlILLS <br />BUII.DI.lIG DRPARIIIEII1' <br /> <br />ONRER'S fWIE ) ~ <2- R-l.t <br />, <br />ONRER'S ADDRESS ,-('L ~ €P 'f <br /> <br />JOB ADDllItSS J: A/Y\e <br /> <br />r~ fZ AN j () 1\ I <br />H ()I L La ,,/ :;t:::!-Z- <br /> <br />LEGAL DKSCIUPl'IOII: IDI'(S) <br /> <br />IOLf <br /> <br />.IILOCIL-SUBDIVISIOR <br /> <br />PARCEL I.D.' <br />... <br /> <br />WORK PROPOSED:_lIev Construction ~tion _Alteration ---..RePair _Inst:a11 <br /> <br />_Sign <br /> <br />---'Iove <br /> <br />_De.olish <br /> <br />PROPOSED USE: <br /> <br />Single Fam.1y <br /> <br />_H/F <br /> <br />_, o.f Unit:s <br /> <br />_H/B <br /> <br />_ec-ercia1 <br /> <br />_Indust. <br /> <br />_Swi.-. Pool <br /> <br />Ot:her <br /> <br />______esl:8urant 5: Hea1t:h Deparblent Approva1 <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />~e Feet, <br /> <br />Height <br /> <br />RESIDKNTIAL: ATrAaI (2) PIDI' PLAIIS 5: (2) SEI'S OF BUIl.DIRG PLAIIS 5: (1) SET ElIERGY fURItS... <br />COItIIERCIAL: ATI'AaI (3) SEI'S OF BUllDIIIG PI.AIiS 5: (1) SKI' ElIERGY FORIIS... <br />..oopy OF OOllTKAGr RIlQUlRIID. <br /> <br />Pll:RftI1S KEOUESTED <br /> <br />pUILDING <br />--1tLECI'RlCAL <br /> <br />$ <br /> <br />Va1uation o.f Tot:a1 Construction <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---1IECIIANICAL <br /> <br />$ <br /> <br />Valuation o.f Hechanical Inst:allation <br /> <br />_PLUllBIRG GAS ROOFIIIG <br /> <br />SPECIALTY <br /> <br />TYPE OF OONSmUCI'IOII: ----..Block --"ra.e _Steel <br /> <br />Ot:her <br /> <br />FIRISBED FLOOR ELEYAnOllS: <br /> <br />fT. <br /> <br />IS PROJEGr IN FUJOD WRit AREA! <br /> <br />YES 110 <br /> <br />.......................................... <br /> <br />BUll"''''' ,~ <br />Sigoat~ , <br /> <br />aJJII.RACIOR SECI'IOll <br /> <br />fDlPARY I!f r<J S '\ M 1#/ Af.. (//11<) C'tfZ.t' Ie (" . . <br />;17 I .. j. Sl:ate Cert. or Regist.' ~ tJ tJ)</ Y- / L/ <br />i&2.........V'- ~ City License Regisb:ation t 2.- <br />.......................................... <br /> <br />RI.RCTRICIAN <br /> <br />aIIlPAIIY <br />State Cerl:. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />SiPIIAture <br /> <br />PLUmER <br /> <br />aIIlPARY <br />State Cert. or Regist. t <br />City License Registration , <br />.......................................... <br /> <br />Signature <br /> <br />IIEaIAlfICAL <br /> <br />WllPARY <br />State Cert. or Regist. t <br />City License Regisb:atioo. t <br />.......................................... <br /> <br />Signature <br /> <br />DI1IJI:R <br /> <br />aJIIPARY <br />Sl:ate Cert. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />Signature <br /> <br />APPLICAnOR APPROVED BY <br /> <br />PERllIT OFFICER. <br />