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<br />APPLICATION FOR PERKIT <br />CITY OF Z.EPIIYKHIUS <br />BUILDING DEPARI'fIENT <br /> <br />qftLu/;L 9?irlf <br />gy <br /> <br />OWNER · S lWtE E f) (;J I/- JZ. D :r A- L \I I S <br /> <br />PHONE <br /> <br />OWNER' S . ADD:RESS <br /> <br />mBADDUSS 3770~ ~~Oa <br />LEGAL DESCRIPI'lON: LOT(S) ,Of #- <br />PARCEL LD.' '3 - Uo..- 7-1 -- 0 I~O - OOJ.DD '- 07 q, 0 <br /> <br />BLOCK <br /> <br />SUBDIVISION .. <br /> <br />... t <br /> <br />WORK PROPOSED:_Nev Construction _Addition _Alteration _Repair ~ Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_D~lish <br /> <br />PROPOSED USE: <br /> <br />Single Fa.ily <br /> <br />_H/F <br /> <br />_' of Units <br /> <br />_H/H <br /> <br />_ec-ercia1 <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />Other <br /> <br />_Restaurant. & Bea1th Departllent Approval <br /> <br />BUILDING SIZE: S~/Z. X Sf Tt. <br /> <br />~e Feet. <br /> <br />Height <br /> <br />RESlDEN1'I.AL : <br />COtVIERClAL : <br /> <br />ATI'ACH (2) PLOT PLAIlS & (2) SETS OF BUILDING PLANS & (1) SET ERERGY FORKS. <br />AtTACH (3) SILTS OF BUILDING PLANS & (1) SET ENERGY FORIIS. . <br />PROPERTY SURVEY REQUllUID FOR AU. JOl.W OONSTRUC'l'ION. (O(L(/t,IZT~ SU5.> <br /> <br />r: t1- {JR.l Vii lUft Y <br /> <br />LJT{c(r"l. /Z~ <br />Valuation of Total Construction <br /> <br />PERHITS B.mUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />?(X)O .00 <br /> <br />_ELECTRICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.G. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />_PLtJHBUIG <br /> <br />GAS <br /> <br />ROOFIIIG <br /> <br />SPECIALTY <br /> <br />TYPE OF OONSTRUC'l'IOIi: _B1oclt _Fra.e _Steel (bN::!/2R:!C.- <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FI' . <br /> <br />IS PROJECI' IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />BUILDER <br />Signature ~ 't1dok <br /> <br />CONTRACI'OR SECITON <br /> <br />cotIPAllYP\-\ ff\~r\\U ct-Q.em{":'(\-\- \~. <br />State Cert. or Regist. , \ <br />City License Registration , ~ <br />****************************************** <br /> <br />F.T.F.CTRICIAli <br /> <br />COHPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />Siml#lture <br /> <br />PLtJHBER <br /> <br />COtIPAIY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COtIPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />arRF.R , <br /> <br />COHPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />riR&tTOFf'IcEk . <br />