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<br />APPLICATION FOR PERlIUT <br />CITY OF ZEPIIYRIIILLS <br />BillLDUilG DEPARlHE'NT <br /> <br />OWNER'S MAMER ,~'" ~'\) ~ ~ ~~~ ~ <br />OWNER'S ADDRESsS q 3 C) 8 \ \4.. S l <br />JOB ADDRESS toCC)3l ~\)~ \\, L ~ ~"E:.- S)~ \)~ <br />lo <br />:3 -;~~-a ( -<@ b-r;-:~ =-~ oo3'd -000 e> 6) .. D~ ~O <br />.~ <br />IroRK PROPOSED:~mreW' Construction ---P'Wdition _Alteration _Repair _Install <br /> <br />PlIO~ ~ 62 -- '-.0 C1 ~~ <br />2 t=. ~ ~ y .f2- ~ ) \..\ ~ <br /> <br />LEGAL DESCRlPTION: WY(S) <br /> <br />BLOCK <br /> <br />StmDIVISIOINJ SIP D~ /<:,1 .3 <br /> <br />G u:::,~ LoT G <br /> <br />PARCEL LD.' <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_De-.olish <br /> <br />PROPOSED USE: <br /> <br />~gle <br /> <br />Faaily <br /> <br />_KIF <br /> <br />_' of Units <br /> <br />_H/H <br /> <br />_CoImIercial <br /> <br />_Indust. <br /> <br />_Swi.. Pool <br /> <br />Other <br /> <br />BUILDING SIZE :'::J'g. \0 'r x.5 b J <br /> <br />_Restaurant & Health Departllllent Approval <br /> <br />\ \1 '13 <br /> <br />Square Feet, <br /> <br />lC) <br /> <br />( <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COKHERCIAL : <br /> <br />ATTACII (2) PLOT PLi\NS & (2) SEIS OF BUILDING PlANS &: (1) SET ENERGY FORMS. U <br />ATTACH (3) SlITS OF BUILDDlG PLANS & (1) SET ENERGY FORMS.-!:'-!:' <br />**COPr OF COIMTRACT REQ1JJIRED. <br /> <br />~ <br />BUILDING <br /> <br />~=CAL <br />_MECHANICAL <br />~UHBING <br /> <br />PEmtITS REOUF_'iTED <br /> <br />$ 'l~)(j~~ <br />\5b <br />~q~~ <br /> <br />ValDa/Of Total Construction <br /> <br />AMP Service Florida Power COrp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />GAS <br />TYPE OF CONSTRUCTION: V:IOCk <br />FINISHED FLOOR ELEVATImilS: q~--t" IT. <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />_Pralle _Steel <br /> <br />Other <br /> <br />/ <br /> <br />IS PROJECT IN FLOOD ZONE ARE.."-? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />COln'RACI'OR SF-cr'ION <br /> <br />BUILDER ~[~ _,.' COIHPAHY <br />~ St:ate Cert. or Regist. 4IF <br />Signature "~ City License Registration !It <br />***************************-!:'************** <br /> <br />ELECTRICIAN f- t:::. ~ _ OO'ltPANY t: EE, Sl_:~.. '---I ~ '-- ,- <br />: ~ ~ -.;!;!;:- St:ate Lert. or Reglst:. 'IF <br />Si ature ~ r ~.- City License Registration f 51:::.) <br />/ ****************************************** <br /> <br />PLmffiER c.~ ~sr--,,--L ~ OO'!tPMllYCD ~ ~,Ll../~ D L'0 ~,\S~:> ' ~ <;;.,... <br />\t\""'--" n State CerL or RegisL 1# <br />Signature ~ JEJ-X .(Pz...,~ City License Registration I bK <br />********************************-!:'******-!:'*-!:' <br /> <br /> <br />OO!tPANY I\) ) 'k..., f?-o ~ <br />State Cert. or Regist. f <br />City License Registration ~ <br />************************-!:'*****-!:'*********-!:'-!:' <br /> <br />'~s.~ <br />..... <br /> <br />Signa t:ure <br /> <br />OTHER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. 1# <br />City License Registration * <br />************************************-!:'**-!:'** <br /> <br />APPLICATION APPROVED BY '11 i.Uh..cCj /l1~ <br /> <br />PEIt..'lfIT OFFICER. <br />