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<br />APPLICAnOR FOR PElUlIT <br />CITY OF ZEPIIYRBIU.S <br />BUILDIRG DEPARTKERT <br /> <br />onER'S RAIlE eJ~~l~ It! (!aGP. PHORE b~/- s.s-~ <br />OWRER'S ADDBBSS li65D tl:3RlFeeG:N~{{)~t; ~K hlJ_ -;;!i"PJPH- <br />JOB ADDRESS /507 ~ e<II.o. 5'1(!J1ef?.:tI::-O/~D <br /> <br />LEGM. DESCRIP'l'IOR: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISIOR <br /> <br />PARCEL I.D.# (OBTAIR FROM PROPERTY TAX ROTICE) <br /> <br />WORK PROPOSED:~ew Construction --..Addition ---..Alteration hpair _Install <br /><<. <br />IlEftJlc5 <br />.lltj#7/N9 <br /> <br />_Sign <br /> <br />---Ifove <br /> <br />->>e8olish <br /> <br />PROPOSED USE: ~ingle F8IIily <br /> <br />---.Jt/F _' of Units ---.Jt/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _OtJ;1er <br /> <br />. _____estaurant Ii: Health Departaent Approval <br />DESCRIPTIOR OF WORlt: L/6'/I7}/vC; Rl?7?zv;:::/rq... (/P~R/90t,F" f/b7< ,c)77"~#e-O S.k'~#_ <br />, <br /> <br />BUILDIRG SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDBHTIAL: ATTACH (2) PLOT PLARS Ii: (2) SETS OF BUILDIRG PLANS Ii: (1) SET BERGY FORMS. <br />COHHERCIAL: ATTACH (3) SETS OF BUILDIRG PLANS Ii: (1) SET BERGY PORMS. <br />PROPERTY SURVEY BEQUIRED POR ALL REW CORSTRUCTIOR. <br /> <br />PERMITS REQUESTED <br /> <br />-BUILDIRG <br />~crJUCAL <br />~ClWlICAL <br />----..PLUKBIRG <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />AIIP Service Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Valuation of lIechanical Installation <br /> <br />GAS ROOFIRG <br /> <br />SPECIALTY <br /> <br />TYPE OF CORSmuCfiOR: <br /> <br />R]ocIr. _Praae _Steel <br /> <br />Other <br /> <br />FIlIISIIED FLOOB. ELEVAnOIlS: <br /> <br />Fr. <br /> <br />IS PROJECT IR FLOOD ZORE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />COBTRACTOR SECTIOR <br /> <br />RMIJ)RR <br /> <br />COHPARY <br />State Cert. or Regist. # <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />RT.RCTRICIAR <br /> <br />COIIPARY F=JP~ ELG"{! 7'<. j ~ ;r7V~. <br />State Cert. or Regist. # ECOoool/Kh <br />City License Registration' ~~. <br />.......................................... <br /> <br />Simuature <br /> <br />PLUMBER <br /> <br />COIIPARY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />IlECllARICAL <br /> <br />COIIPARY <br />State Cert. or Regist. . <br />City License Registration f <br />.......................................... <br /> <br />Signature <br /> <br />OTRRR COIIPARY <br />State Cert. or Regist. # <br />Signature City License Registration . <br />.......................................... <br /> <br />APPLICAmHI APPIIlIVIlD BY ~ A<r ~ J1! ~~ PBIlIIIT OFfiCER. <br />