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<br />APPLICAnON FOR PEIKlT <br />CITY OP ZEPIIYBlITI.Lq. <br />BUILDING DEPAR'l'KENT <br /> <br />~ ~U~-IO ~ ;10-9<'-::- <br /> <br />OWNER' Slwm H IJ I!.K l( / $LS / f SCH fYJ Iff.ff J? <br />/ <br />OWNER' S ,ADDUSS Lor- S- J . 10 ()J~ R.J J::) f:r E.. \.tJ It '( t) fJ.. I' <br />JOB ADDRESS S )'/1 m IE:-. <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br />PARCEL I.D.t. 3- d.lo7.1/ ,..;.()/.$D.- tZI:::<<J-t!>S7o (OBTAIN FROM PROPERTY TAX ,OT1CE) <br /> <br />PHONE <br /> <br />7J?:2-:)r27b <br /> <br />DESCRIPT'IOII OF WOBK: Sfl~.j) - CI7R...PLJlZr- CPA/~,e.€TE <br /> <br />BUILDING SIZE: 7:x It> . S-olD Square Feet.~eiaht <br /> <br />~IDEllTIAL: AnACB (2) PLOT'I'LABS II (2) SETS OF BUILDDlG PLANS '& (1) SET ENERGY FORMS. <br />COHHERCIAL: AttACII (3) SITS OF BUlLDDlG PLANS {( (1) SET EllERGY FOBHS. <br />PROPDrY SURVEY BBQUDUm POll ALL NEW CONSTRUCTION. <br /> <br />V;U:W~~G <br /> <br />PRRHITS REQUESTED <br /> <br />$ <br /> <br />J S?t),()O <br /> <br />ValuatiOa. of Total Construction <br />I <br /> <br />RlRC.nu.CAL <br /> <br />AIIP Se;rv~ce <br /> <br />Florida Power Co~. <br /> <br />W.R.B.C. <br /> <br />----lIEaI.!UiICAL <br /> <br />$. <br /> <br />Valuation of llecbanica1lnstallation <br /> <br />-RUKlBDlG <br /> <br />GAS <br /> <br />ROOFDlG <br /> <br />SPECIALTY <br /> <br />. . <br /> <br />TYPB PF COBSTJUJCnOH: <br /> <br />~lock, ~"!fM! _Steel. <br /> <br />Other <br /> <br />PIIIISIIBD FLOOIt BLBVAnOBS: <br /> <br />FT. <br /> <br />IS PBOJECr IH FLOOD ZOO AREA! <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />BIJJT.DBR <br /> <br />CONTRACTOR SECTION <br />mtlPAIIY /J~ ~t{,#7. <br />J21i.r~ ~~te Li~ ~~~~~ ~.e-G7~ <br /> <br />.......................................... -- ~ <br /> <br />Signaturll! <br /> <br />F.T .RCTRICl6ll <br /> <br />CoHPABY ' <br />State Cert. or Regist. . <br />City License Registration' <br />...*...................................... <br /> <br />S i &mil turl:!: <br /> <br />PLUMBER <br /> <br />COHPAIIY <br />State Cert. or Beaist. . <br />City License Registration f <br />......................................*... <br /> <br />Sigoaturl~ <br /> <br />HEClWlICI\J. <br /> <br />, COKPAIIY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Sigoaturl~ <br /> <br />OTRF.R <br /> <br />COHPAIIY <br />State Cert. or Regist. . <br />City License Registration . <br />.............*............................ <br /> <br />Signature <br /> <br />APPLICAnOli APPBOVED BY <br /> <br />PERK1T OFFICER. <br />