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<br />'$ <br /> <br />APPLICATION FOR PERKlT <br />CITY OF ZIW1II.KlIlLLS <br />BmJ.DUIG DEPAR'nIEn <br /> <br />OWNER'S NAffE <br /> <br />Cn.:ro\ "'. ~~O~'V() <br />ADDRESS lotoL-\ ~ N(),\-h <br />Ze--0hLr,~ \ \ \ ~ <br />~O <br /> <br />PRONE <br /> <br />C)RO -" tJ;1~6 I <br /> <br />OWHF.R ' S <br /> <br />Ln ke C"fJ't-. <br />CtL. ,3"66LJ I <br /> <br />.JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOI'(S) <br /> <br />BJncK <br /> <br />SUBDIVISION ~ '\ \ De'I' <br /> <br />[)Q~S <br /> <br />PARCEL I. D.' <br /> <br />"'URK PROPOSED:_~ev Construction _Addition _Alteration --.Repair _Install <br /> <br />_Sign <br /> <br />_lPtove <br /> <br />_De..olish <br /> <br />- <br />PR6POSIID USE: <br /> <br />Single Faaily <br /> <br />_"'F <br /> <br />_, of Units <br /> <br />_HI" <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_SwbI. Pool <br /> <br />Other <br /> <br />_Rest:aurant &: Healt:h i)epart:Jlent Approval <br /> <br />RUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />GOHHERCIAL : <br /> <br />ATTACH (2) PI..O'I' PLARS &: (2) SE'IS OF BUILDIJlIC PLANS &: (1) SF.T F.'NF.RGY FORP1~j. H <br />ATTACH (3) SE'IS OF BUII.DDlG PLARS &: (1) SEI' ENERGY FORKS. ** <br />......COpy OF COlNTRAcr RIl'QUTRIlD. <br /> <br />.. <br /> <br />PERIPIITS REOtJP..sTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Tot:a1 Construct ion <br /> <br />_ELECTRICAL <br /> <br />NIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.f:.C, <br /> <br />_MECIIMlICAL <br /> <br />s <br /> <br />Valuation of "echanica.1 Inst:allation <br /> <br />_PLUPtBTIfG <br /> <br />GAS <br /> <br />ROOFDIG <br /> <br />" <br />SPECIALTY <br /> <br />TYPE OP CONSTRUCTION!: _Block <br /> <br />_Pralle _Steel <br /> <br />Other <br /> <br />P'UfISlIED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FT.ooO ZONE ARPA? <br /> <br />................................................................................................ <br /> <br />YES NO <br /> <br />P.T.F.CTRICIAN <br /> <br /> <br />CIJIlITRAC1'OR SECTION <br /> <br />~ C1lIIPAXY_W.Q.~ c.....I. f'...._. <br /> <br />O State Cert. or Regist.' ooZOt Z-'1 <br />"' ,~ City License Registration , "/ <br />.................................................................................................................* <br /> <br />RUILDER <br />S ignat:ure uJ <br /> <br />Si <br /> <br />? '- <br />cmrpARY U?J?~~///~~-A~ Y-~ <br />St..ate Cert. or Regist. , rJDv (.. 'i t s- <br />City License Registration , _ ~ [) 0 <br />................................................................................ ................... <br /> <br />~-~ <br /> <br />PLUKBER <br /> <br />COIfPARY <br />/7" _ A ~ ~ St:ate Cert. or Regist,. , <br />~ ~~ City License Registration , <br />.............................................................................................................. <br /> <br /> <br />Signature <br /> <br />mKPMY XJN-G...(.:? e~.l-J <br />State Cert~ or Regi~i. # ()cD 1"( / ~ <br />Signature City License Registration' 7/ <br />~ ~ \ .....................................................................................................* <br /> <br />cmw.R G V OOPIPAJIY t1A~J h;1~;~t:: <br />./ ~ /1 State Cert. or Regist. . Lc '?(1~'t ~/ <br />Sigfuature -7i.-'" C------. City License Registration. 3 ~. <br />*........................................................................................................... <br /> <br /> <br />.\PPLICATIOlil APPROVED BY <br /> <br />PERKIT OFFICER. <br /> <br />----- <br />