|
<br />,....
<br />
<br />It.Pl'LlCAnON FOR. P8RKIT
<br />CITY OP ZEPlIYBPlT.T $
<br />BUILDUG DEPAR'l'HEN'f
<br />
<br />OWNER'S 'NAt1K GEiJI<.~ . (},ftJPfI..{'O
<br />
<br />OWNER'S ,Al)I)USS J>~'bt) J b z::ct /It/C.
<br />
<br />, PHONE
<br />
<br />JOB ADDllE:SS
<br />
<br />vJ9jtJ€ '
<br />
<br />LEGAL DHSClUPtlO,,: L01'(S)
<br />
<br />BLOCK
<br />
<br />SUBDIVISION
<br />
<br />PARCEL ':(.D.I. I /~ ).t:. J-J::" 0010--- / '3 700_ 0 it J (QPT4IH ~OM PROP~Ft~ TAtl~Q.'U.G,t}.
<br />WORK PROPOSED: V)lew' eon&truCtion --...Addition ---Alteration Repair _...~I.r.~ tt...ll
<br />
<br />~i&U
<br />
<br />~ve
<br />
<br />---.D~lisb
<br />
<br />v" '"
<br />PRO.PQSEI.l USE: -JiI18le FilIitily
<br />_ec..ercial ,
<br />
<br />,---.J:i/F
<br />
<br />_t,of,UnibJ --HIU
<br />
<br />_~t. ---.Swia., Pool, _Otl:lcr
<br />
<br />Res tau.r~t fJ Health Departaent Approval
<br />
<br />'J"
<br />_BU1'(~ODlG
<br />
<br />DESCRIP'l"ION OF WOnK: ell/? PI) to- r
<br />BUIIJ)DlG Sl2.B: / r x .J.~ , f/1 Square Feet, ,. if) i ' Ueight '
<br />
<br />, ',I f ~ ",-," *,. , f'
<br />RES1DEli'Jl"u.L: ATrACll (2) PL01' .fWS , (2) SETS OF BUILDING 1>>L.UlS " (1) SET mUmGYFORtlS.
<br />COnL-1fRCr..I\L: AT'l'AW (3) SiTS, OF BUILDING PLANS fJ (1) SlIT ENERGY FORKS.
<br />PROllERTY SURVEy" ~unum FOli ALL NEW CONSTRUC'lION.
<br />.' I., - .
<br />
<br />, '" , ' PRRKITS JEOU~STED
<br />/ J"'OO .00 Valuation' of Tocal Construction
<br />,
<br />
<br />$
<br />
<br />RT p.::.l'RICoU.
<br />
<br />AIIP Se;rv~ce
<br />
<br />Florida Power Coep.
<br />
<br />W.R.E.C.
<br />
<br />---llEC:LiAHICAL
<br />~Lll'mDlG
<br />TYPE 9P 4COHSTRUC':t'l;OM: ,
<br />
<br />$
<br />
<br />V~ti.OI1 of Hechanical Installation
<br />
<br />l ~ , "
<br />
<br />GAS
<br />
<br />ROOFING
<br />
<br />S:rECL\LTY
<br />
<br />. ,
<br />
<br />.'
<br />It.l~, _Fr~ _Stee.).
<br />
<br />Other
<br />
<br />...' ..' ,r,:, ~
<br />
<br />Y.un:SBE,I~ FLOOli ELEVAnOHS:
<br />
<br />FT.
<br />
<br />IS PllOJECT IN FLOOD 20N2 ~f
<br />
<br />YES
<br />
<br />NO
<br />
<br />.**~~~!.*~.****.....**.***.*..**..***....*
<br />
<br />, I
<br />
<br />Signature
<br />
<br />~~
<br />
<br />CONTRACTOR SEC"I' c.l
<br />
<br />mHPAHY .. ' /lCE.,tfL.tf pl "
<br />
<br />State Cert. orRegiat~ I: C~C,G 3lf6.F-D
<br />City License Registration f J> ,1'
<br />*****.~**.*.**...*.********.*****.***..*..
<br />
<br />~, I'
<br />
<br />. ~. ~ ; /'
<br />
<br />BUll DRH:
<br />
<br />EI.HC'l'RI~(Ali
<br />
<br />,,"" j COMPANY'
<br />State ~rt. or Regist. f
<br />City License Registration'
<br />.**_..*..........._-*......_-*-*-_........
<br />
<br />S i ROil tUJJ~
<br />
<br />PI,UMBER
<br />
<br />COMPANY
<br />State Cert. or Beaist. ,
<br />City License Registration t
<br />****..*****.******-**.*.********.*********
<br />
<br />Signatu r4~
<br />
<br />{f
<br />
<br />HECHAHl~~
<br />
<br />, COMPANY
<br />State Cert. or Regist. ,
<br />City License Registration.
<br />**.****************-**************....**.*
<br />
<br />Signaturl~
<br />
<br />OTH F.R
<br />
<br />***_..a*_*****it"
<br />
<br />COKPANY
<br />State Cert. or ReSist. .
<br />C.f.,r Licen.&e Regiatratioll ,
<br />~*******-*.**.*******
<br />
<br />S igo.a t,; Ire
<br />
<br />APPLICJ'nON APPRot'ED RY _
<br />
<br />PERMIT OFFICER.
<br />
|