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<br />APPLICATION FoR PERKIT <br />CITY OF ZEPIIYRIIILLS <br />BUILDING DEPARTHERT <br /> <br />1/ kn.-e <br />Jy!:f <br />5 <br />LEGAL DESCRIPTION: LOT(S) J e, BLOCIL--SUBDIVISIO <br />It. PARCEL LD.' 03- z.fo -2/- of 100 -00000 '- 02.. e 0 (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />OWNER'S BAtIE <br /> <br />C~~4s <br /> <br />OWNER'S ADDIlBSS <br /> <br /> <br />Iv", . <br /> <br />, <br /> <br />hkJ <br /> <br /> <br />JOB ADDRESS <br /> <br />WORK PROPOSED:~ew Construction ---Addition ---Alteration -.Jepair _Install <br />_Sign -.JIove --->>eaolish <br />PROPOSED USE: ...xsingle Faaily ---ll/F _' of Units ---ll/H <br />_ec-ercial _Indust. _Swia. Pool _Other <br /> <br />-.Jestaurant it Hea1th Departaent Approval <br />DESCRIPTION OF WORK: 5i~J~ f'~.ly Il~-s.d-e..,f4 ^'~ I/om-v <br />L . Jt# F' W~I'S <br />BUILDING SIZE: S-7 X vi) ,;),'18(0 Square Feet, Height <br /> <br />RESIDERTIAL: AT1'ACII (2) PLOT PLARS it (2) SETS OF BUILDING PLARS it (1) SET ERBRGY FORKS. <br />COtIHERCIAL: AT1'ACII (3) SETS OF BUILDING PLARS it (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />X BUILDING <br /> <br />)( IU.RCTRICAL <br /> <br />~CIIAlIJ.CAL <br />Y ,,-, <br />~UM8ING <br /> <br />~ ~ PERKITS REQUESTED <br />$ I Dj, S-DO.;tj Valuation of Total Coostruction <br />/ SO AHP Service Florida Power Corp. <br />$ -#3YvOIZ <br /> <br />W.R.E.C. <br /> <br />GAS <br /> <br />Valuation of lIechanica1 Installation <br />X ,.jelel <br />ROOfiNG <br /> <br />SPECIALTY <br /> <br />TlPE OF COIlST.RUCTIOR: ~loclt _Fraae _Steel Other <br /> <br />x FIlIISBBD FLOOR ELEVAnOIlS: Cf I Fr. IS PROJECT IN FLOOD ZONE AREA' X <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION' <br /> <br />~ RUIIJ)RR ~b1 COMPANY ,i / 4~ an/r-~-hK.$/::r~ <br />- State Cert. '1- YOo1,L1J.t.' c: (.) <br />Signature City License Registration . <br />/ .......................................... <br /> <br /> <br />A IU.RCTRICIAR COMPANY $~....... ~/ev/v-" <br />::-:- t'J 0 State Cert. or Regist.' ell- 000 7-.79~ <br />Sf " e X Vt' ~ C~ City Liceose lle8iotroUon' ,;; ~/ <br />.......................................... <br /> <br />PLIDIBER <br /> <br /> <br />COMPANY /3~o~ I ;o/&.);..j~ <br />~~ State Cert. or Regist.' C 0'1 Z'I'1 BO <br />",?t..l'ZiT" City License Registration . 9/ <br />.......................................... <br /> <br />Signature <br /> <br />.\. IlECBANICAL <br />Signature ~ <br /> <br /> <br />Il,S tl:g , <br />COKPANY~ m-1t0b ~ +EJ€GJ <br />State Cert. or Regist. f C!A~:1Y-~ ~. . <br />ity License Registration . <br />.................................... <br /> <br />OTRRR J I <br />Signature _'-lf4-~ P.UJL~ <br /> <br />APPLICATIOlI APP1IOVBD BY '1/ a~ m (t[J. ~ <br /> <br /> <br /> <br />PEBHIT OFFICER. <br />