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<br /> <br />/~ftv/) 9-Jllr71f <br /> <br />(!r9/c pAOf'V<::- /O~ ffil2tf:'f'V <br />13/3-. d(l./O-IS- ?V <br />L-e~v<:.. /77"f!!'$S4c5 '<- <br />PHONE &"1 3- 10::; 3 -4c2 7J- <br /> <br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARntENT <br />, <br /> <br />OWNER'S NAHK <br /> <br />\~ ~1Z-I< <br /> <br />FLAL~ ')'1'/1 H :SALes <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />3 7 ~Li ~ <br /> <br />.PL/fC-e <br /> <br />WORK PROPOSED:__ew Construction --...Addition ---^iteration ---.Jlepair _Install <br /> _Sign --.JIove -Deaolish <br /> /' <br />PROPOSED USE: _Single Feaily ---1l/F _' of Units ..-.6/H <br /> _ec-ercial _Indust. _Swia. Pool _Other <br /> <br />---.Jlestaurant rr Health Departaent Approval <br />DESCRIPTIOR OF WORK: ~ 0 131 Le... /-I0Fr7 -e S e r u ~ <br /> <br />BUlLDIRG SIZE: ct; ~ X 'I r. <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDBRTL\L: ATTACH (2) PLOT PLARS rr (2) SETS OF BUlLDIRG PLARS rr (1) SET ERBRGY FORMS. <br />COtlKERCIAL: ArlACH (3) SETS OF BUlLDIRG PLARS rr (1) SET ERBRGY FORHS~ <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CORSTRUCTION. <br /> <br />~ <br />-BUlLDIRG <br />V;;RcnuCAL <br />~CIL\II1CAL <br />~~~niG <br /> <br />PERKITS REQUESTED <br /> <br />$ {-? S; OOOr 0" Valuation of Total Construction <br /> <br />I .5-0 AIIP Service Florida Power Corp. <br />00 <br />$ 9 () 0 .:--- Valuation of tlechanica1 Installation <br /> <br />W.R.E.C. <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CORSTRucrIOR: .-Block _Fraae _Steel 17l06.1e ~~ther <br /> <br />FIIIISBBD FLOOR ELBVAnOBS: <br /> <br />F'l'. <br /> <br />IS PROJECT IN FLOOD ZORE AllBA1 4 <br />YES NO <br /> <br />.......................................... <br /> <br />BIITlnRR <br /> <br />CONTRACTOR SECTION <br /> <br />mKPARY /il~ /hc <- /77 // ~es <br />d State Cert. or Regist. . <br />r'~ City License Registration' 0 H )1 330 .H <br />*................................ <br /> <br />COMPANY ~ /01'0./ e/l/e ~C1/\JS <br />~ State Cert. or Regist. . <br />t::' City License Registration' ,d.5:' Y <br />........................................ <br /> <br />COKPARY A-Rf ;::%c-~ $# J};Les <br />'. LState Cert. or Regist. . <br />.,.,;er City License Registration' l')/~ // 3JcJ /7- <br />*............................... <br /> <br />COIIPAIIY ~$v<k<vv ~..-w1...., ,f--,.-7', ;,c. <br />State Ce t. or Regist. . <br />City License Registration f j ~ ~ <br />........................................ I <br /> <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />APPLICAnOR APPROVED BY <br /> <br />PERKIT OFFICER. <br />