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<br />'1 <br />JOB ADDRESS /)~~1 tJ5~ ~~d, ~l7/1 17, '1~~'-If <br />LEGAL DESCRIP'llON: LOT(S) 1 st T 3 -r I/, I.~ -{ SUBDIVISI: I~ ~~~. <br />PARCEL 1:.D.# (OBT N _ _~_ TICE) <br /> <br /> <br />APPLICATION FOR PElUlIT <br />CITY OP ZEPII!IUIllJ:.S <br />BUILDING DEPAR1'KBIiT <br /> <br />~~Wt;~"'];;;;'~ . <br />tft1 ~rL; 0 ;? &-rl1 fyez., <br />If ~q' ~/(f <br />-18,~ -,,:p.~-1 <br /> <br />-,--~"......,~~.....!".........-.,<~~.-..,...- <br /> <br />OWNER' S' <br /> <br />0WlIER' S ADDRESS <br /> <br />WORK PROPOSED:-Rew CoDstructioo. ----..Addition --...Alteration -.Jlepair _Install <br /> -/--sign ---Kove ->>eaolish <br />PROPOSED USE: ----/iiDg].e P8IIi!y --1f./F _' of Units --1f./H <br /> _ec-ercial _Indust. _Swill. Pool _Other <br /> <br />, ~estaurant Ii: Health Departaent Approval <br /> <br />DESCRIP'llOR OP WORK: In...7Jf;ujd/(on al uJtJOdPA ,-:1 ..dldM/ ':;;7/7. <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />~uare Peet. <br /> <br />Height <br /> <br />RESIDEI1TIAL: ATTACH (2) PLOT PLARS Ii: (2) SETS OP BUILDING PLARS Ii: (1) SET EBERGY PORMS. <br />COMMERCIAL: ATrACH (3) SETS OP BUILDING PLARS Ii: (1) SET ENERGY PORKS. <br />PROPERTY SURVEY REQUIRED POR ALL NEW CORSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELEcrRICAL <br /> <br />A!IP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />----lIECIIAlIICAL <br /> <br />$ <br /> <br />Valuation of llecbanica1 Installation <br /> <br />.-PLtllBDG <br /> <br />GAS ROOFDfG <br /> <br />SPECIALTY <br /> <br />TYPE OP mRSDUCTIOR: <br /> <br />R10cIt _Praae _Steel <br /> <br />Other <br /> <br />FDlISHED FLOOR ELEVATIORS: <br /> <br />Fr. <br /> <br />:IS PROJECT IR FLOOD ZOIiB ABEA'l <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />BlrrT.Dn <br /> <br /> <br />COliTRAcroR SECTION <br /> <br />Signature <br /> <br />mtlPAIIY <br />State Cert. or Regist. # <br />City License Registration .. <br />.......................................... <br /> <br />RT .RCTRTCIAIIl <br /> <br />Sionature <br /> <br />COHPARY <br />State Cert. or Regist. . <br />City License Registration' <br />.......................................... <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />COMPARY <br />State Cert. or Regist. .. <br />City License Registration .. <br />.......................................... <br /> <br />IlECllAliICAL <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration . <br />.................*************.**..******* <br /> <br />Signature <br /> <br />~. COIlPAIIY ~l:C[-\ SIG.1J5 <br />~ ;'~Q State Cert. or Regist. . <br />>' . D City License Registration' (2) ...3 .~ <br />~ ......................................... <br /> <br />flTIIIm <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />