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<br />OWNER'S IWIE '~j)k MWI~ <br />OWNER'S ADDRESS ?;~(?h M/>ftfJr<< Z-fill1"(}S1J1 L1h I 1/G, <br />JOB ADDRRSS~?;lJ ~{ 01. <br /> <br />PHOn <br /> <br />'~~DI\ (/(OIC!<(; <br />C;v6D7-C16 <br />#trtJ'-;.,_ ;e1;- <br /> <br />~[Jt1< r{~11.r' 68t6f; <br /> <br />APPLICATIOl!ii ~OR PERHIT <br />CI'IY OF ~.EPIlYEPILLS <br />B1llII.DlliG DEPAR1'!fE'.m' <br /> <br />r12-r ~ I~V~ <br />~ /q? <br />\f O"'~/; <br />t <br /> <br />LEGAL DESCRIPTImI: I.OT(S) <br /> <br />JII.OCK <br /> <br />SUBDIVISIOlli <br /> <br />PARCEL LD.' <br />ttORK PROPOSED :_lIiev Construction _Addition ./ A1teration _Repair _Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_DeIaolish <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_SwUI. Pool <br /> <br />_K/H <br />eM ~ j;(M. Other <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />_"IF <br /> <br />_' of Units <br /> <br />~estaurant &: Hea1th nepan:.ent Approva1 <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDElITIAL : <br />COHKERCIAL : <br /> <br />A'l'TACII (2) PLOI' PI...MiS &: (2) SEIS OF B1llII.DIlIiG P:L.4UiS &: (1) SEl" ENERGY FORMS. ** <br />A'l'TACII (3) SEIS OF BUllDDG PI...MiS &: (1) SEl" ENERGY FORMS. ** <br />**COFY OF COIiITRACT RE'Q1JlIRIlD. <br /> <br />PEKKlTS REQUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Va1uation of Tot:a1 Construction <br /> <br />_ELECTRICAL <br />LKECHAliICAL <br /> <br />AKP Service <br /> <br />Florida Power COrp. <br /> <br />W.R.E.C. <br /> <br />$ ~O.O() <br /> <br />Va1uation of Hechanica1 Installation <br /> <br />_PLUKBING GAS ROOFDiG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTIOlli: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FlliISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZOBE AREA? <br /> <br />YES NO <br /> <br />...*...*.......v~............*......*...** <br /> <br />COlIiTRACIOR SECTION <br /> <br />COIIPANY <br />State Cert. or Regist. , <br />City License Registration , <br />............*..**......................... <br /> <br />BUILD~ <br /> <br />Signature <br /> <br />ELECTRICIAN <br /> <br />amp.o-Jt <br />St.ate Cert. or Regist. , <br />~1L$ L1ceuse Keg1stracion . <br />......*.*********........**........*.***** <br /> <br />5iRDaiLu1-e <br /> <br />COIIPAJNJY <br />State Cert. or Regist. , <br />City License Registration I <br />**.*.**~**~*.~*+*~~*...********.*.*.**..** <br /> <br />PLUKBER <br /> <br />Signature <br /> <br /> <br />Signature <br /> <br />>\RY~,zt: t}PRIl'l~ 1i'lC- <br /> <br />State Cert. or Regist.' n08/, OOD/77 <br />City License Registration I 7.3 <br />******..********v****************.**. <br /> <br />CG!IPARY <br />State Cert. or Regist. I <br />City License Registration , <br />**********..***********~.*****.*****..**.. <br /> <br />0T1IltR <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />