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<br />APpt,lCATION fOR PERftlT <br />CIlT Of" ZIl:mTRBII.LS <br />BUILDING PEPARJftfr.NT <br /> <br />.....ER.S IWI. J ~I'IN /lJ" ti/), Y heffl'd~ T.4tvdmo.. <br />OWNER · S ADDRESS S 8 ~ 'f G' ,q / / Lf L v to <br />S ;"f r'h L <br /> <br />.JOB ADDRESS <br /> <br />,LEGAL DESCRIPI'101M: Wr(S) <br /> <br />BIAJCK <br /> <br />SUBDIVISIOR <br /> <br />PARCEL I.D.' <br /> <br />WRI{ PROPOSED:_lNfew c:onstruction _Addition _Alteration _Repair -K-Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_DeIIOHsh <br /> <br />PROPOSED USE: <br /> <br />Single Fa.i1y <br /> <br />_KIf" <br /> <br />_, of Units <br /> <br />_PliO <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Swill. Pool <br /> <br />~/c <br /> <br />Other <br /> <br />_Restaurant. & Health Depart~t Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet.. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />(:otUtERCIAI. : <br /> <br />ATTACH (2) PLOI' PIJUlIS & (2) SEIS OF BUILDING PLMS & (1) SKI' ENERGY FORKS....... <br />ATTACH (J) SEIS OF BUILDING PLANS & (1) SEI' ENERGY FORKS....... <br />......COPY' OF CONTRACT' Rl!'QllI'IRllD. <br /> <br />PERlIIlI'S REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />;'99$"~ <br /> <br />Valuation o~ Total Construction <br /> <br />_ELEGI'RlCAL <br /> <br />AKP Service <br /> <br />Florida Power COrp. <br /> <br />W.R.E.C. <br /> <br />_"F,("'1IANlCAL <br /> <br />$ <br /> <br />Valuat ion of Mechanical Installation <br /> <br />~PUJ.tBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF GONSTRUCTIOIM: _Block _I"r:.e _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR El.IWATIOBS: <br /> <br />FI' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />.........~..........~............~.................................................................................. <br /> <br />YES NO <br /> <br />QJJIlU'RA(''TOR SEGI'IOR <br /> <br />BUILDER <br /> <br />COIfPANY <br />Slate Cert. or Regist. , <br />City License Registration , <br />.............................................................................................................................. <br />'1 <br />ELECIRlCIAR/, " mlPlPANY/I~ ~ t:' h-N rJ C.e "'~ .C/",L L E LEe 7' Kt'c4L.. <br />. lJ ~ State Cerl. or Regist.. , <br />Sismat.ure ;1) -u~/{ L,~~ City License Registrat.ion t -2 1/"0 <br />........................................................................................................................ <br /> <br />Signature <br /> <br />c~7. <br /> <br />PLUflBER <br /> <br />aJIIPANY <br />Stale Cert.. or Regist. , <br />City License Registration f <br />................................................................................................................ <br /> <br />Signature <br /> <br />ltIl:C'HARlCAL <br />Signature ~~ 5~ <br />t7 <br /> <br />WPlPMIY .6)'J /// J ~(t'J/J /'1 r/ f G /? S -e.. 11/( <br />State Cerl. or Regist. f <:;f coy ..5 '7 y g' <br />City License Regist.ration f 78' <br />........................................................................................................................ <br /> <br />OIHF.R cortPARY <br />State Cert.. or Regist. , <br />Signature City License Regist.rat.ion I <br />............................................................................................................................ <br /> <br />APPJ.ICATION APPROVIJD BY PERPIlT OFFICER. <br />