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<br />",~~~,~,""",,,.--.,_..-..,.-. <br /> <br />APPLICAnON FOR. PERKlT <br />CITY OF zEPBY.BBILLS <br />BUILDING DEPARTHERT <br /> <br />OWRER'S lWIB S ~'l' -;y{26&t/ ld~~1?~ PHONE 78.2- J// / <br />OWRER'S ADBUSS 3B~/.6-} (f fJ/5/h'rt ,1:7 CJ''''p " :Z..e,t?~l2h/ds. I~ <br />JOB ADDRESS "38t?/f? .J/?P$'I'##) P&'r. .;' S~~IjM0~~//Jf;{" &~'?~ <br />/ <br /> <br />LEGAL DESCllIP'lIOII: LOT(S) <br /> <br />B~SUBDIVISIOH <br /> <br />PARCEL LB.# :2 - Z-.2/-t?tJ/d -o510~-o-L10~ <br /> <br />(OBTAIN FROH PROPERTY TAX NOTICE) <br /> <br />---..Restaurant & Health Departaent Approval <br />DESCRIPnOIl OF WORK: ~ 1-1 cA~/"w .l/-i,/f h/1'C4f!.. <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDEIITIAL: ATTAaI (2) PLOT PLANS & (2) SETS OF BUILDIIIG PLANS & (1) SET ERERGY FORMS. <br />COIIMERCIAL: ATTAaI (3) SETS OF BUILDING PLANS & (1) SET ERERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL HEW COIISTRUCTION. <br /> <br />~UILDING <br /> <br />PERKITS REQUESTED <br />$ ~ ()~I ~ Valuation of Total Construction <br /> <br />RT.RcnuCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-"ECIWIlCAL <br /> <br />$ <br /> <br />Valuation of Kechanica1 Installation <br /> <br />---.-.PLutmING GAS <br />TYPE QF COIISUUCTIOII: ____...loclt <br /> <br />ROOFDlG <br />_Fr~ ~eel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />PIllISBED FLOOJl ELEVAfiOIlS: Fl. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />/, <br /> <br />YES NO <br /> <br />..............*............*.......*...*.. <br /> <br />Signature <br /> <br /> <br />CONTRACTOR SECTION <br /> <br />aJHPAIIY 7 ...e.p/'?'" V/? <br />State Cert. or Regist. . <br />City License Registration . <br />...........*..*.**...... <br /> <br />...... <br />/-c........JC-F <br /> <br />BUn.DRR <br /> <br />s-rJ <br /> <br />RT .RCTRTCTAII COHPAIIY <br />State Cert. or Regist. . <br />Sianature City License Registration' <br />...*.......*.....*..*....*.......**..*.*** <br /> <br />PT.I1MBRR COKPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />................**............*....******. <br /> <br />IIBCRAlfI.CAL COHPAIIY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.*.................*......**..***.**.**..* <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration . <br />...*...............*.*..........*......... <br /> <br />APPLICAnON APPIlOVED BY PERHlT OFFICER. <br />