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<br />APPLICATIOlV FOIt PERKIT <br />CITY OF ZEPHIKll.l..LLS <br />BUILDDIG DEPA.R1lIUlXT <br /> <br />JOB ADDRESS <br /> <br />;&;/ii 2101AWlJ <br />1,/2.3 ~<1J 2L <br />Cl~ <br /> <br />PIIOH 8/3 -7g~~~Z76 <br /> <br />OWNER'S KAtIE <br /> <br />OWNER'S ADDRESS <br /> <br />LEGAL DESCRIPTION: IDI'(S) <br /> <br />BJ.OC1( <br /> <br />SUBDIVISIOlV <br /> <br />PARCEL 1. D. t <br /> <br />'1--2-6 -J.../ - tJ/3.{;) -oooc:;o- 070.0 <br /> <br />WRK PROPOSED :~lVev Construction ~tion _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_l!Iove <br /> <br />_Deao1ish <br /> <br />PROPOSED USE: ~ Sing1e Faai1y ,;, _II/F <br /> <br />_, of Units <br /> <br />* K/H <br /> <br />_ec-ercia1 _Indust. <br /> <br />_S,"-. Poo1 <br /> <br />Other <br /> <br />_Restaurant &: Bea1th ~t Approva1 <br /> <br />BUILDIlfG SIZE: Z 'i' X b f '8' " <br /> <br />jtf3?- <br /> <br />Square Feet, <br /> <br />/~~7 <br /> <br />Height <br /> <br />, RESIDERTIAL: <br />, COttKERCIAL : <br /> <br />ATTACH (2) PLOI' PI.AIIS &: (2) SEI'S OF BUTI.DIMG PLUS &: (1) SET ENERGY FORKS....... <br />AITAaI (3) SEI'S OF BUll.DllIG PLMiS &: (1) SEt' mmRGY FORKS....... <br />......COpy OF COBTRAC'f REQUIRED. <br /> <br />L-BUILDI'NG <br />~ELEC'l'RICAL <br />~ItEaIAlIICAL <br />lPLUKBIlfG <br /> <br />$ <br /> <br />PRRI!ITTS REOUESTED <br />3tf'tJ1J Va1uation of Tot:a1 Construction <br />/ SO AIIP Service F10rida Power Corp'. <br />1301) -- Va1uation of Hechanica1 Installation <br /> <br />*W.R.E.C. <br /> <br />$ <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF COBSTRUCTIOl!il: _B1oc1t <br />FTI!IISIIED FLOOR ELEVATIONS: fJ /;.r--FT . <br />I <br /> <br />_Pralle _Stee1 <br /> <br />)/h I.J.-~ <br /> <br />Other <br /> <br />IS PRO.JECI' Di FLOOD ZONE AREA? <br /> <br />YES <br /> <br />NO <br /> <br />....................................********.................................................................. <br /> <br />BUTTnER <br /> <br />c:mrI'RACI'OR SECTION <br /> <br />if ~ IDIPAIIY /./-.a. ~ <br /> <br />.A State Gert. or Regist.1 <br />,'I.hJ ~ City License Registration' '3C;-/o <br />/ . ......**...~....................................................**......*......*.....................~...... <br /> <br />Signature <br /> <br /> <br />e <br /> <br />PLUtBER <br /> <br />~ , IDIIPAIIY QU8lJ7J ~AtJ <br />. State Cert. or Regist. f <br />, City License Registration I /~~y <br />...........................**.......................~++++++............**.*** <br /> <br />. Signature <br /> <br />awJMI~ ~ <br />Signature ~;b~4 J4; . <br /> <br />OOIIPARY fJ.4hI1tS //2b,P~ <br />State Cert. or Regist. I <br />City License Registration I <br />.........**......~............****.....................*....................................**.........* <br /> <br />~' ,'14-<- <br />7'il- <br /> <br />0'r1IF.R <br /> <br />OOIIP.DY <br /> <br />Signature <br /> <br />St-at-p f".PTf: _ or Reri.st. " <br />City License Registration . <br />...**.....................**..................**............ . ~ '{..~.. :'. <br />MI! .'!""'. ,.~..~' <br />'It .,C', ". <br />) ...... iwUnT <br /> <br /> <br />OFFICER. <br /> <br />t <br />