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<br />APPLICATION FOR PEmfiT <br />ex ic'Y OF ZEPHYRllIUS <br />BUILDlliG DEPARnIfJ'NT <br /> <br />OWNER'S MAKE <br /> <br />PROSE <br /> <br />OWNER'S ADDRESS <br /> <br />9t I, 5'i- <br /> <br />, <br /> <br />LEGAL DESCRIPTION: I.OT(S) 17 {l / Lf. <br />g- /- I) 6- j/-(JtJl/ tJ <br />PARCEL 1. D .1 rr- <br /> <br />f Lf f I- <br /> <br />2 eLJ 0 t rt/l'(('7 Pj, 7) 5"~' Q <br />{ <br />B1OC1{ /} 0sUODIVISIOlti / 19 J <br />-/ 6.00-0-/3.1// <br /> <br />JOB ADDRESS <br /> <br />WORK PROPOSED :_!NIev C'onstruction ~tion _A1teration <br /> <br />Repair ~Inst:all <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />~iJJg1e <br /> <br />Faaily <br /> <br />_KIF <br /> <br />_, of Ulnits <br /> <br />_KID <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_Swill. Pool <br /> <br />Ot:her <br /> <br />_Restaurant &: Hea1t:h nepan:.ent Approval <br />BUILDING SIZE: 1" b xn. ~ ~ L{ <br /> <br />Square Feet, <br /> <br />f(/ <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COHKERCIAL : <br /> <br />AlTACH (2) PLOI' PLAIIS &: (2) SEI'S OF BUlLDDIG PI..US &: (1) SET EHERGY FORKS. ** <br />ATTACH (3) SEI'S OF B1JII.DDiG PLAIIS &: (1) SET EHERGY FORKS.** <br />**COPY OF CONTRACT ~. <br /> <br />PEmIITS REQUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />$ <br /> <br />A!IP Service <br /> <br />f7f? ?:~ <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />ELECTRICAL <br />V HECHAJnCAL <br /> <br />Valuation of Kechanical Installation <br /> <br />TYPE OF CONSTRUCTION: _Block <br /> <br />ROOFING <br />~Fraae _Steel <br /> <br />sptCIALTY <br /> <br />_PLUKBING GAS <br /> <br />Ot:her <br /> <br />FII!iISHED FLOOR ELEVATIO]tiS: <br /> <br />FI' . <br /> <br />IS PROJECT IN FLOOD ZOSE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />C05I'RACIOR SECTION <br /> <br />COIIPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />ELECTRICIAN <br />~5-e...L- <br />Sismature <br /> <br />COIIPANY ~ ()J e r .7 r;: I ~ [1/' ; C- <br />aft;~~ Stat.e Cert:. or Regist:. , __ <br />City License Registration I .2'5 I <br />****************************************** <br /> <br />Signature <br /> <br />COItPANY <br />State Cert. or Regist:. :f <br />City License Registration 1 <br />******.*********~*****~**~~++.************ <br /> <br />PIHtBER <br /> <br />Signature <br /> <br /> <br />COItPANY 0 r <br /> <br />State Cert. or Regist:. I <br />City License Registration I <br />************************** <br /> <br /> <br />(1'-1'1( (f( ?'1'7 <br />J <br /> <br />KECHAlUCAL <br /> <br />OTHER COIIPARY <br />State Cert:. or Regist. :f <br />Signature City License Registration , <br />****************************************** <br /> <br />APPLICATION APPROVED BY pERftTY OFFICER. <br />