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<br />APPLICAnON fOR PERfIIT <br />an OF ZEPIIYRIIIllS <br />BUlLDllIG DEPARJIIENT <br /> <br />OWNER · S RAttE <br /> <br />;<;/ <br />. ~/ /7 // - <br />/cA;--e_ /;5c>{/ y4/lf' ~. c. <br />, <br /> <br />JOB ADDRESs3J~ b Y /~ <br /> <br />/ <br />.a~~t'V L~'J.-/ /c)c)_ <br /> <br /> <br />PIIO~c.O'3) Y?~.> . c.f:">vo <br /> <br />C;7jr . ./?' ,-X3S'V;;/ <br />~ <br /> <br />OWRER'S ADDRESS ;,?,j' 7 (_;7{)~t:r .A'7z.,Y? ./ ~/;:/e.r <br /> <br />LEGAL D~CRIPJ'IOI!I: LDI(S) <br /> <br />//] <br /> <br />BLOCK <br /> <br />SUBDIYISIOIi .~e~><::LeJ WCk/ c:r~~r <br /> <br />PARCEL LD.' <br />WRK PROPOSED:~ Construction -.JWdition _Alteration _.Repair _Install <br /> <br />_Sign <br /> <br />_lIove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />L-~le Faaily <br /> <br />_H/F <br /> <br />_' of Units <br /> <br />_H/H <br /> <br />_c:c-ercial <br /> <br />_Indust. <br /> <br />_SwW. Pool <br /> <br />Other <br /> <br />_Restaurant &- Health Depart:aent Approval. <br /> <br />(, r'" <br />BUILDING SIZE: 3(.1,(' X 1'2 . <br /> <br />~ 2 CrtJ <br /> <br />~e Feet. <br /> <br />l?'/ <br /> <br />Height <br /> <br />RESIDEIiTIAL : <br />COttHERCIAL : <br /> <br />AnACII (2) PlOJ' PLAIIS &- (2) SEI'S OF BUII.DING PLAItS & (1) SET ElllERGY FORMS. u <br />AnACII (3) SEI'S OF BUII.DUlG PI.AIIS &- (1) SET EllERGY FOKH5... <br />..OOPY OF OONI'HACf KJll!UIRED. <br /> <br />PEHHI.TS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Val.uation of Tot:al Construction <br /> <br />____ELECTRICAL <br /> <br />./..,.-DO <br /> <br />AtIP SeJVice <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---llECllAlfICAL <br /> <br />s <br /> <br />// !SuO> c;o <br /> <br />Val.uat:ion of Hechanical Inst:allat:ion <br /> <br />_PLUKBIIIG GAS ROOFING <br />TYPE OF OONSTRUGTIOR: -LLBiock _Fraae _Steel <br />" <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FlIlISHED FLOOR ELEVATIOI1S: <br /> <br />I'T . <br /> <br />IS PKOJECf IN FLOOD ZOIlE AREA! <br /> <br />~ <br />YES NO <br /> <br />.......................................... <br /> <br />m5'1'RACIOR SECI'ION <br /> <br />~~ UJ. W!lPANY /:~ 'c,lfe .&~/' /;:k...r _-"::;1c <br />. , I State Cert. or Regist.' cdc ()Cj/"r9?J <br />Signature "" ~ _ /...U City License Registration' 3 :?2_ <br />-- ........ .............................. <br /> <br />:CTRI::M '7 ~ W!lPMfY ~~//?>~ 6~/C $(.,15 I~e., <br />~ State Cert:. or Regist. , 15"" A:. CI 0 / () '/.:J'~ <br />_~tu_ _' City License Registration' ;Z .:t c/ <br />........... ...................... ..... / <br /> <br />BUILDER <br /> <br />PLUlBER / <br /> <br />sigoatureOl ~~ <br /> <br />W!lPANY <br />State Cert:. or Regist. , <br />City License Registration , <br />.................**.-._..-...*...~~..~.... <br /> <br /> <br />HECllAMICAL W!lPAtlYt3~ONO ~ool/~~ f' #("".cJ',~.G <br />d I /.J -..p.I.L.. State Cert. or Regfst. , ~ A OO~O SO <br />Signature -li/ Un ,) <I ~../.Lo.uJ " City License Registration , J {J j;, <br />~. '.. *uuu......................*uu*uuu*uu*u . ' <br /> <br />~ K.< t~7 I< 4# OOIIPAIIY t('c/~ ~f::;-_.- <br /> <br />. ra.;;p.~ ~ State Cert. or egfst:. I <br />Signature ~. City License Registration , <br />~7 -----.-~._-~~-~......................................."...... <br /> <br />APPLICATION APPROVED BY PEBKIT OFFICER. <br />