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<br />APPLICATION FOR PRRHIT <br />CITY OF ZEPIIYRHTLLS <br />Bm.I.DllUG DEPAR'DIJ!',]IIJT <br /> <br />JOB ADDRF..5S ~ <br />t.EGAL DESCRIPTION: LOT(S) JIg- BLOCK SUBDIVISION <br />oARCEL LD.t /0- Z h - Z/- Olr:? 0-- 00000 - O)};) <br /> <br /> <br />PRONlE---1Yi,.J) ;>or - ~ D<fO <br />~ <br /> <br />~W'NER'S <br /> <br />'lW'NER · S ADDRESS <br /> <br />','URK PROPOSED:_~ Construction _Addition _Alteration ~e-pair _Install <br /> <br />_Sign <br /> <br />_I!tove <br /> <br />_De.olish <br /> <br />PROPOSED USE: <br /> <br />~ Faaily <br /> <br />_KIF <br /> <br />_, of Units <br /> <br />_M/H <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_Swi.. Pool <br /> <br />Other <br /> <br />_Rest:aurant &: Hea1t:h ))epa.rt:.en.t Approval <br /> <br />1UILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />~ESIDENTIAL : <br />--;QHKERCIAL : <br /> <br />ATTACH (2) PLor PI..MilS &: (2) SElS OF BUILDING PLARS &: (1) SET ENERGY FORMS. U <br />ATTACH (3) SETS OF BUII.DDiIG PLANS &: (1) SET mmRGY FORKS. ** <br />....COpy OF CONTRACT REQUJJIRED. <br /> <br />.. <br /> <br />PERKlTS REQUE.'iTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AftP Service <br /> <br />Florida Power Corp. <br /> <br />~R.E.C. <br /> <br />_HECHMITCAI. <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _~ _Steel <br /> <br />Other <br /> <br />'~INISlJEl) FLOOR ELEVATIO]IIJS: <br /> <br />FI' . <br /> <br />IS P.RO..JECT IX FLOOD ZONE: AREA? <br /> <br />YES NO <br /> <br />...............................................................................** <br /> <br />COln'RACIOR SECTION <br /> <br />~ CDltPAJIY.J,J. !lflJ~. !I'I ~ IV""" CvjJ. &, <br /> <br />((1 0 ~ State Cert:. or Regist:. f OtJZ08 .... 'I <br />, -.' 'lj~ City License Registration , 'I <br />....................................................................* <br /> <br />l\l1ILDY.R <br /> <br />';ignature <br /> <br /><". <br />~1 <br /> <br /> <br />OO!IP~ ~~ V~. ~- <br /> <br />State Cert. or Regist. , <br />City License Registrati.on f J--tJ C:, <br />........................................................*.... ........ <br /> <br />PLUKBER <br /> <br />~.e.~ <br /> <br /> <br />COIfPMY <br />State Cert. or Regist,. f <br />City License Registration t <br />.........................................................***..............** <br /> <br />"tF:,CRANICAL C CDltPAJIY X/I" 5' PL/ c;, r4' ,~ <br />. ~ / /A J /? State Cert:. or Reg{st:. f 60 ~ ~ ' <br />S1gnatur~, . C/v' .' ........-.- City License Registration t , <br />') I ..................................................*............................* <br />. I <br /> <br />{/~ // ( <br />0'I1tF.:~ /' <br /> <br />Signatur~ 4CL c... <br /> <br />Signature <br /> <br />CO!tPAfi 71./1 ' <br />State Cert. or Regist. f <br />City Li.cense Registration <br />................................................................................... <br /> <br /> <br /> <br />\PPLICATION APPROVED BY <br /> <br />PERIIfIT OFFICER. <br /> <br />'~A-j~ ~~7-1:l-/y <br /> <br />___..at <br />