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<br />APPLXCAnON FOR PIBKIT
<br />CITY OF ZEPIIYBBTll ~
<br />BUD.DUG DEPARTKEN'.f
<br />
<br />~;~'li/15
<br />
<br />OWNER'S twm (;'€O(<6rE- S'rJSAKA
<br />OWER'S ADDUSS ~r:-yq/..f?/~ t!iJ/lK.r~1f., sr.
<br />JOB ADDRESS ~\JtffmE. '
<br />LEGAL DESCIUl"fiOH,: LOT(S) BLOCK SUBDIVJ:SION
<br />PARCEL I.D.t /'I-~ ...c2J-t''!:)\70 - tJt>~ - a:JPn . (OBTAIN FROM PROP~'J'YT~ ~91'ICln
<br />WORK PROPOSED: ~ew' Coaatwctioll --..AdditiOll ~teration Repair ~~tall
<br />
<br />PHONE
<br />
<br />ltP':;-c2~7~
<br />
<br />~
<br />
<br />Sian
<br />
<br />~ve
<br />
<br />--->>e.olish
<br />
<br />PlWPQSED USE: VSiDale 'F~
<br />, " ,',.,
<br />
<br />,--Jill"
<br />
<br />_' of Units' --Ji/B
<br />
<br />....' : t :''!\
<br />_eo-erci.U" , ,
<br />
<br />I 1'0 '
<br />
<br />_lDduat.
<br />
<br />Swia~ Pool ':-"OtJ;1er
<br />
<br />Reataur8ILt II Bea1th Departaent Approval
<br />DESCRIPT [011 OF WOU:, oSLfl.tt . '" , "/J-1I 0
<br />BUD.DING SIZE: :x ',;)'J~ Square Feet, ?,.o '7 Heipt
<br />
<br />, ,..'" , ,'..,.: , (
<br />RESJ:DEliTlAL: ATrACII . (2) PLOT .l'LAIIS II (2) SETS OF BUD.DING P!.AHS & (1) SET UERGY ,FomIS.
<br />COHKERCJ:U.: ArrACU (3) SETS OF BUlLDUG PLANS & (1) SET ElIERGY foaKS. .,
<br />, P~P~~~~,: B,BQWJW) . FOIl ALL ,HEW COIISTIWCTION..' ,
<br />
<br />t:., "
<br />
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<br />_BUD.l>ING ,
<br />
<br />, . I ,,-', .,) 'f.)
<br />
<br />P~~S ~O~TIID
<br />
<br />$~
<br />
<br />c!rtJ. 00
<br />
<br />ValuatiOa' of Total CoDS~ruction
<br />" , '
<br />
<br />R1 RCtRICAL
<br />
<br />~.Service
<br />-<'T ,'" ".'.;
<br />
<br />, Florida Pow~r ,Corp.
<br />
<br />W.R.E.C.
<br />
<br />~C8WCAL
<br />--PLUKRDlG
<br />
<br />$
<br />
<br />
<br />Valuat10ll of tf.ecbacUc.I. lu&1:allation
<br />
<br />ROOFDlG
<br />
<br />SPECIALTY
<br />
<br />TYPB 91" l::;QIISTJWCnQN:
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<br />Rl~, --J~
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<br />, s~.J.
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<br />Other
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<br />.;.;'"._ ;i', ;.
<br />
<br />l'DiISBED n.ooa BLBVATIQIiS:
<br />
<br />"' w,' ; ,: ISPJWJECr U ,fLOOD ZONE .AlBAT
<br />
<br />. - 'I < . ~
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<br />',\ .~.':.' . \ ':'1:/:'
<br />
<br />YES
<br />
<br />NO
<br />
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<br />
<br />.........***......*...*..***.*****.**..***
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<br />
<br />, CONTRACTOR SECTION
<br />
<br />. I';:. ,:.0
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<br />'i -,';", .i\ ';',
<br />
<br />
<br />Sisnatur~:ll
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<br />.. a>>m ' </lcE
<br />State Cut. or aeg1&t~ I.
<br />City License Regi&tration .
<br />**************..**************************
<br />
<br />Bun.DRR
<br />
<br />RLRCTRIC'(.AI.
<br />
<br />;,...,..~, CoHPAHY .
<br />State Cert. or Regist. I.
<br />City License Registration'
<br />****.****..,.**..***************.*********
<br />
<br />Si aruttur.~
<br />
<br />PLUMBER..
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<br />
<br />. COHPAHY '
<br />State Cert.or Resiat. I.
<br />City Licenae Registration .
<br />,***....****************.*********~.....**..*****
<br />
<br />..~. '
<br />
<br />SigDatur~~
<br />
<br />.:I.:. j.., . ! .~; \-,:) ": l
<br />
<br />HECHAHICJI.L
<br />
<br />'". ;....
<br />
<br />, COHPAHY
<br />State Cert. or Regist. I.
<br />City Licenae Registration .
<br />*~**~~***~~*..******************.*.**.****
<br />
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<br />...' I. ". .J ~
<br />
<br />SigDaturo
<br />
<br />OTRF.R
<br />
<br />******
<br />
<br />COKPAHY
<br />State Cert. or Regiat. .
<br />City Liceaae Beaistration I.
<br />-*******************************
<br />
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<br />
<br />Si8Qaturlll
<br />
<br />APPLlCATlON APPllOVED BY
<br />
<br />PERKIT OFFICER.
<br />
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