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<br />AP1JLlCATIOIf POll PEIIKlT <br />CITY OP ZIPBYRBILLS <br />BUlLDIIIG DIPARTMlIIT <br /> <br />OWHIR t S 11.lHR~ i <br /> <br />OWIBR t S <br /> <br /> <br />JOB ADDRISS <br /> <br />LEGAL DISCRIP'rIOI: l.OT(S) <br /> <br />BLOClt <br /> <br />SUBDI.VISION <br /> <br />PARCEL I.D.' (O,TAUJ PROM Pmpon TAX ~Q'tm~) <br /> <br />...,JUt PItOPOSBDI____ew Ooaatruetion ---Addition ---Alteration --Jlepair _lnatall <br />--1Jian --.JIove --Peaolish <br />PROPOSED USI: ~lna1o Faaily --"IF _' of Units --Jt/a <br />/eo..erCla1 _Induat. _SWUI. Pool _Other <br /> <br />Restaurant & Health Departaent Approval <br /> <br />DBSCIIP1'IOII or tIOB.. tJAofw/YYI.) ~~~ <br /> <br />IUllJ)1JIG SlZIt X Square Feet. Beiaht <br /> <br />USIDDTlAL: AftACIl (2) PLOT PLANS & (2) SETS OF BUlLDIBG PLANS & (I) SBr DEROY PORKS. <br />COKKBRCIAL ~ ATTACH (3) SBTS OF BUILDING PLtafS II (1) SBT ENERGY PORHs. <br />PIIOPBRTr StJRVBY R8QUIRBD FOR ALL NBW CONSTRUCTION. <br /> <br />---JUlLDDIG <br /> <br />$.3 l)~q8,oo <br /> <br />rEPKlTS REOURSTIm <br /> <br />Valuation of Total Construction <br /> <br />1a.RC1"BICAL <br /> <br />AIfP Service <br /> <br />Plorida Power Corp. <br /> <br />N.R.I.C. <br /> <br />---.JIBCIIAftCAL <br />--..PIAMIUG <br /> <br />* <br /> <br />Valuation of tleclum.ical Installation <br /> <br />GAS <br /> <br />ROanNG <br /> <br />SPBCIALTY <br />Other <br /> <br />TIP! OF COIISr:aucrtOI. -Block -Prue _Stee!, <br /> <br />nII.SIIBD I'I..OOa BLBYATIOIIS ~ <br /> <br />-FT. <br /> <br />IS PROJECT 111 FLOOD ZONE AlIA, <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />f.\QNTRACTflll SEcrION .2...5 ""3 -. c.rV <br /> <br />~. tnfpAft \AIUJfoWVYl )~{I'fP. - ~tJlP i) <br />State Cert. or a.aist. I L!.(! 7J <br />Sisnature , City License Registration . <br />..... · ..............t................... OJG ..,->-0 <br /> <br />RI.RCTJlTI!U". . COMPANY Y- // E j E c.. HI C!.- c..t:J <br />~/ ~ State Cert. or Reatat.' ...C/2,?100-9'?1Z <br />Sfonature .~ City Licana8 ~81etratiOD' <br />........................................ <br /> <br />IlJTl.no. <br /> <br />PUDlRp <br /> <br />COKPANf <br />State Cert. or Reatat. . <br />City Licenae Registration . <br />.......................................... <br /> <br />St.aoature <br /> <br />IIRCIWIT CAJ. <br /> <br />r llt L .4 <br /> <br />cotIPANY <br />State Cert. or ReSist. . <br />City License Regietration, .., <br />.......................................... <br /> <br />Stanature <br /> <br />O'I'RD <br /> <br />CO!tPAHY <br />State Cert. Of' 1lo81et. . <br />City tlcen.e Registration . <br />.......................................... <br /> <br />Sisnature <br /> <br />APPLlCAnOll ArPI.OVBD BY '-1!a /It,(' A.-1 ill Ih9 j}~1 <br />CJ Q <br /> <br />PBRMlT OPPIClIt. <br />