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<br />APPLICATION FOR PERKIT <br />GITY OF ZEPIIYRIIILLS <br />BUILDllIG DEPAR'IItENT <br /> <br />OWNER"S <br /> <br />lWtE ,:;tl,Se- ~N,) <br /> <br />ADDRESS 3773 yo AJ ~t.UA L <br /> <br />54-Ju.~ <br /> <br />4v'i... <br /> <br />mONE ;?;3-ZR2-22.76 <br />/ ;C~/HY-L/hZ4" /-~ 3=3~;;~1' <br />, <br /> <br />OWNER' S <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPl'IOR: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1.0.' <br /> <br />t:J3 --2(;, - ).../- t:J/3.o -~o ,00 - eJz6. 0 <br /> <br />WORK PROPOSED:~Nev Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_D~lish <br /> <br />PROPOSED USE: <br /> <br />Single F_ily <br /> <br />_H/F <br /> <br />_' of Units <br /> <br />~H/H <br /> <br />_eo..ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />BUILDING SIZE: t..S Xbb'g", <br /> <br />~re Feet, <br /> <br />/ 'f)m.~ <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COIVIERCIAL : <br /> <br />ATI'ACB (2) PLOT PLUS & (2) SEI'S OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />ATI'ACB (J) SETS OF BUILDDiG PLANS & (1) SEI' ENERGY FORKS. <br />PROPERTY SURVEY REQtmIED FOR ALL ImW CONSTRUCTION. <br /> <br />~ BUILDING <br />~ELECIRICAL <br />~ ttECBARICAL <br />~ PLOIBING <br /> <br />$ <br /> <br />PERKITS REOUESTED <br />.2~ ?.rv Valuation of Total Construction <br />, <br /> <br />IS'?} <br />AIIP Service Florida Power Corp. <br /> <br />~ W.R.E.C. <br /> <br />$ <br /> <br />/~ <br /> <br />Valuation of Hechanical Installation <br /> <br />GAS <br /> <br />ROOFIBG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCl'ION: _Block _Fr_e -==--.Steel <br /> <br />/J1#- <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />Fr. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />BUILDEI\ ~ <br />Signatureh ..- <br /> <br />CONTRACTOR SECTION <br /> <br />cotIPAliY #' ~ /Z- ~ <br /># State Cert. or Regist. . <br />~~ City License Registration' 3<;:b <br />****************************************** <br /> <br />F.I.F.CTRICIAR COMPANY C' -" N- ~a..a- ~C;-c;~ <br />~/J~~ 24 / State Cert. or Reg{st. . <br />Sil:m~turw~~ ....~/~ ~City License Registration' 3\" <br />( .**************************************** <br /> <br />PLUttBER ~ COMPANY fi,1-J~ 4-.-/ <br />L State Cert. or Regist. I <br />Signature ~ City License Registration . /?J&- <br />/ v ****************************************** <br /> <br />~ <br />Signat-- ~ <br /> <br />COttPANY~A.~ ~pP~ C:~ .~ A <br />~ ~ Sta<e Cer<. or llegis<. . <br />City License Registration .;;??" <br />****** *********************************** <br /> <br />OTIIF.R . <br /> <br />COtIPANY <br />State Cert. or Regist. I <br />City License Registration I <br />*.**************************************** <br /> <br />Signature <br /> <br />APPLICAnOll APl'IllIVED BY 'i1 d1L.l'"(J ~~--u <br /> <br />PERIflT OFFICER. <br />