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<br />APPLICATIUN FUR PERKIT <br />CITY UF ZEPIIYKIIILLS <br />BUILDING DEPARIIt.ENT <br /> <br />r<;f ~~JL.1-1? :57~ <br />1f,.t20?~ <br /> <br />OWNER' S ADDRESS <br /> <br />S-5 z.'1 <br />5~2-9 <br /> <br />~-s (('UJWE\...L <br /> <br />2-,-\ ~ S'"H7-G?c::-r <br />T1J- <br />24 - ~ee-r <br /> <br />LEGAL DESCKIPl'IUII: I.OT(S) <br /> <br />BLOCK <br /> <br />mURE 8/3) 788' -OZo'-f <br />h-pI~rz.I-M\ \5 I H- 3354u <br />~(l..fhffs r; 33~'Io <br />SUBDIVISIUN <br /> <br />OWNER' S R.AIIE <br /> <br />JUB ADDRESS <br /> <br />PARCEL I. D.' <br /> <br />0070 -- 00000 - 0070 <br /> <br />WORK PKUPOSED:~Bew Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_De.o1ish <br /> <br />PRUPOSED UJSE: <br /> <br />Single Faaily <br /> <br />_tl/F <br /> <br />_, oJ: Units <br /> <br />--1f/H <br />UTI L 1\1 Sth:--oUther <br /> <br />_<=<-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />_Restaurant 5: Healt:h Depart:aent Approval <br /> <br />BUILDING SIZE: <br /> <br />/ Z- X Z-D, <br /> <br />2-<fO <br /> <br />Square Feet, <br /> <br />/2- <br /> <br />Height <br /> <br />.RESIDENTIAL : <br />COHKERCIAL : <br /> <br />ATTACH (2) PLOT PlANS 5: (2) SETS UF BUILDING PLANS 5: (1) SET ENERGY FURMS. <br />ATTACH (3) Sin'S UF BUILDING PLANS 5: (1) SET ENERGY FORftS. <br />PROPERTY SURVEY KIlQUIRED FUR ALL REV WNSTKUcnUN. <br /> <br />PERMITS REQUESTED <br /> <br />,l.-BUILDIfiG $ <br />4ELEcnuCAL <br />4-HECllANICAL $ <br />~PLmmING <br />TYPE UF CONSTKUCITUN: <br /> <br />~<J <br /> <br />2( 2-30 - Valuation of Total Construction <br /> <br />AIIP Service Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />Va1uation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />_B1ock. -LFraae _Steel <br /> <br />Uther <br /> <br />FINISHED FLOOK ELEVATIUNS: <br /> <br />FT. <br /> <br />IS PKOJECI IN FLOOD ZURE AREA? -25- <br />YES NO. <br /> <br />.......................................... <br /> <br />COHTKACI'OR SECTIUN <br /> <br />BUILDER ~ g' GOHPABY <br />: //1 1./7 State Cert. <br />Signature /' ' - ~if0 City License Registration f <br />(_./' ............................................ <br />/' <br /> <br /> <br />ELECIlUCIAR COKPARY <br />State Cert. or Regist. , <br />Silmature City License Registration , <br />.............................................. <br /> <br />PLUMBER GOHPANY <br />State Cert. or Regist. f <br />Signature City License Registration , <br />................................................ <br /> <br />HEGIIMlIGAI. cotIPAIIIY <br />State Cert. or RegisL , <br />Signature City License Registration f <br />.............................................. <br /> <br />OTHER cotIPANY <br />State Cert. or Regist. f <br />Signature- City License Registration f <br />.......................................... <br /> <br />APPLICATIUN APPROVED BY PERKIT UFFICER. <br />