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<br />APPLICATION FOR PERKlT <br />CITY OF zEPBYlUllLLS <br />BUILDIRG DEPAR11tERT <br /> <br />OWNER · S IIAHB (}J C~- PHONE PJ3- 7 ff - ;3 *'J-2-() <br />OWNER' S ADDBESS 47~O W~ DA 2 ~f'~1 A~Jfz. :tt7~ . <br />JOB ADDRESS 47rcJ Iv I ",.:I-i;~ a <br /> <br />LEGAL DESClUFllON: LOT(S) &' rOO <br /> <br />B~SUBDIVlSION () / h () <br /> <br />PARCEL I.D.' <br /> <br />J 6- - ;}.Gt - :;L I <br /> <br />, <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED: I/'""Bew Construction .-Jddition ~teration ~pair _Install <br /> _Sign. ---Hove ---peaolish <br />PROPOSED USE: vSingle Faaily ---Yt/F _' of Units ---Yt/H <br /> _ec-ercial _Indust. _Swia. Pool _Other <br /> <br />DESCRIPTION OF WORK: <br /> <br />.--Jlestaurant &: Health Departaent Approval <br /> <br />JO~O" )I a-r-'-v" ~~ doL ~ fJ~b <br />, <br /> <br />BUILDING SIZB: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RBSlDERTIAL: ATTACH (2) PLOT PLARS &: (2) SETS OF BUILDING PLANS &: (1) SET DERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SBT DERGY FOIUlS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS RROUESTED <br /> <br />.---BUILDING <br /> <br />$ <br /> <br />~ <br />tJ713 <br /> <br />Valuation of Total Construction <br /> <br />RT.RCTRICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />~CIWIlCAL <br />.-PLUHBING <br /> <br />$ <br /> <br />Valuation of lIecbanical Installation <br /> <br />GAS <br /> <br />ROOfiNG <br /> <br />SPECIALTY . <br />~ Other <br /> <br />TYPE OF OOISTRUcnON: ~loclt _Fraae _Steel <br /> <br />Fl. <br /> <br />IS PROJBC1' II FLOOD ZONE AREA? <br /> <br />t..--'" <br /> <br />FllI1SBBD FI.OOIl BLBVATIONS: <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />BIJIIJ)ER <br /> <br />Signature l/;$..dI <br /> <br />coNTRACTOR SECTION <br /> <br />I~ . ':~^_ . '=L.:.r~~~/:~ <br /> <br />I ~LIf/'- City License Registration . <br />.......................................... <br /> <br />t:J 'I,C)77 'L <br /> <br />RT.RCTRICIAII COMPANY <br />State Cert. or Regist. . <br />SigftAture City License Registration . <br />.......................................... <br /> <br />PLmtBER COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration' <br />.......................................... <br /> <br />MECIIAIUCAL COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />vrmm COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />APPLICATION APPROVED BY PBBtIlT OFFICER. <br />