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<br />APPLICATIOII FOR PERfIIT <br />Cl'IY OF ZEPIIYRIIlU.S <br />BUlI.DlJiG DEPARIIIENT <br /> <br />'p"L) r:::- L' <br />n', < / () . '(}rV <br /> <br />OWER'S IWIE ~./~ 6'4f/kJ ,~c. moNE 9W- ~-:/Z2 ~i''2YO <br />, <br /> <br />OWIIER'S ADDRESS ?tP 7 y;~~ Aie. ~/ze.s t!#y .' a' 3.3.SVf' <br /> <br />JOB ADDRESS 4--/- 51 .;J3 ~J~Y' r 2p~~~{/6 / p; 3.3~"i/0 <br /> <br />~'; <br />LF.GAL DI!SCRIP1'lOII: LDr(S) ~(.OCI( SIIBDIVlSIOM M 2C/ d# <br />J;) -:1-6 -~I ~ <br /> <br />PARCEL I.D.' c:2~ -;,2(- /2--' ()OOOO - ~yCi ,- odf'l' <br /> <br /> <br />WRK PROPOSED: ~ev C'oo.s~ruc~ioo ~iUoo _A1~eration _Repair _Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_D~lish <br /> <br />PROPOSED USE: ~gl e Faaily <br /> <br />_H/F <br /> <br />_' of Uni1:s <br /> <br />---"/8 <br /> <br />_<=<-ercial <br /> <br />_Iodus~. <br /> <br />_Swill. Pool <br /> <br />Other <br /> <br />-.Jlesl:auran~ &- Beall:h Depara:.en~ Approval <br />d If ,. <br />BUILDING SIZE: ))/f,g X S'O, /3:27 ~e Feet, <br /> <br />tf/ <br /> <br />Height <br /> <br />RESIDENTIAL: AtTACH (2) Purr PLANS&- (2) SEIS OF BUI.I.DIIIG PI.AIIS &- (1) SET ENERGY FORHS.** <br />cottItEIlCIAL: ATI'ACII (3) SEI'S OF BUI.I.DIIiIG PLUlS &- (1) SET EIIERGY FORHS..... <br />....OOpy OF OON'I'RAcr IUfQUTRED. <br /> <br />F.I.F.CTRICAL <br /> <br />PERKITS REOUESTED <br /> <br />$ "(1), bOO, 6i"l ValuaUon of Tot:al Construction <br /> <br />.;200 AIIP Service Florida Power Coxp. <br /> <br />W.R.E.C. <br /> <br />_BUILDING <br /> <br />---.JtEaIAIUCAL <br /> <br />$ <br /> <br />1r?s-.c>D <br /> <br />Valua~ioo of Hecbanical Inst:allaUon <br /> <br />SPECIALTY <br /> <br />Ol:her <br /> <br />FIRISHED FLOOR ELEVATIOIIS: <br /> <br />FI' . <br /> <br />IS PKOJEC'l III FLOOD ZONE AREA? ~ <br />YES NO <br /> <br />.................................................................................... <br /> <br />BUILDER <br /> <br /> <br />OOlD'RACIOR SECTIOR ----, <br /> <br />OO!IPANY //dfe 0Vv'/ck-/!{' ~ <br />St:ate Cer~. or Regist.' cAe~,.,g? 7S <br />City License Regist:ra~iOll , 1!7 g-- <br />............................................................................ <br /> <br />'v <br /> <br />Signature <br /> <br />Signature <br /> <br />OO!IPMiY e,~/E/ ~ f(~ 5v..s <br />""7. ~ State, Cert. or Regist. 'J3'RoO~:L <br />/1. City License Regis~ratiOll" I 9 7 Y <br />.............. .............................................................. <br />OO!IPAIfY A. C. ' P I VI ~ b) ,fl.j <br />~ 4. ~ Stat:e CerL or Begin. · . <br />, , I- t;ity License Regist.ra~iOll' I 7 q:3 <br />................................................................................. <br /> <br />L/'" <br /> <br />ELECTRICIAN <br /> <br />~~.....turc ;{/~ <br /> <br />./ <br /> <br />PLOIBER <br /> <br />ttECIIAIIICAL <br /> <br />Signature uit T ~ <br /> <br />OO!IPANY 13 c (? ..v ~ Co 171..~'_ ~ I /,,/ t'" a /,"'/r <br />State Cert. or Reefst. ,.... 00 7.7 Jt7 0 r Rt? ~ O?Jd' <br />I City License Regis~ra~ion ,,I-#- ) '7 <br />................................................................................. <br /> <br />t/' <br /> <br />0I1IEK OO!IPANY , <br />Sta~e Cer~. or Reglst. I <br />Signature City License Registra~ion , <br />.............................................................................. <br /> <br />APPLICATION APPROVED BY PERfIIT OFFICER. <br />