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<br />APPUCAnOH FOR PIBKI'l
<br />CITY OF ZEPJlYRHTT' $
<br />BUILDUO DEPAR1'KE.If.r
<br />
<br />_'S lW<Il ,1i?J!/Vc..ES, !/lfrr/il4JJ.
<br />OWER'S ADDUSS 'dJ>tJl'/E;tI~ /11/'&,
<br />,JOB 4DDRESS S),9,DJE' '
<br />
<br />PRONE
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<br />
<br />LEGAL DBSClUP1'IOH,: un'(S)
<br />PARCEL I.D.t
<br />
<br />BLOCK
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED:
<br />
<br />H~W 'CoastruCtioa~itiOll --..Alteration
<br />
<br />.,
<br />(OB~AIN FROM PROPERTY T~'~9T1CE)
<br />
<br />~pair _~tau
<br />
<br />Sip
<br />
<br />>~,',,':.;~ '~ve
<br />
<br />---J)eIIOli5b
<br />
<br />PROPQSED USE:
<br />
<br />~' ,'.,
<br />siQale F_ily
<br />. , .
<br />
<br />, ,---Ji/F
<br />
<br />, _eo..erci:al,
<br />
<br />'J',
<br />
<br />. ,
<br />_lIWw;t.
<br />
<br />~', of. Units' ---Ji/u
<br />swia~. Pool. ,_OtJ;ler .
<br />
<br />hataurant 61 Uealth Departaent Approval
<br />DESCKIPr~OIl ,OF WOK: GL(iI{~tJL)m - EL~~ ~ " . .
<br />BUILDING SIZE: / L'J :x:.:J. i. .;)/D Square Feet, ?,,O'9Ueiaht
<br />
<br />, , ' , ' ',..'.,' ., '''. r '
<br />
<br />RESIDEHTIAL: An'ACB (2) PLOT ..t'LAHS fr (2) Sin'S OF BUILDUO rLAHS , (1) SET BliERGYFORHS.
<br />COHHERCLU.: ArtAQI (3) SETS. OF BUILDDlO PLANS 61 (1) SET ENERGY FOJUtS. '
<br />PIWPERrY sua~:.1lBQUlaED FOR ALL .HEW CONSTRUC"lION.,
<br />
<br />-. Y;~D~O
<br />
<br />'-l.~,~',!.. ~~ > I
<br />
<br />PRRHTTS RF.OURc;TF.Q'
<br />
<br />$
<br />
<br />o//VO.Oo
<br />
<br />Valuatioa. . of Total. Coutruction
<br />I , ,
<br />
<br />RI.Ecnuc.u.
<br />
<br />~ Se;n:4-ce, .
<br />
<br />. Plorida Pow~r eol.-p.
<br />
<br />W.R.E.C.
<br />
<br />--1iEaL\H1ClL
<br />-PL1JK8no
<br />~B PF iCOlIS~ON:,
<br />
<br />$.
<br />
<br />V~tioB of llechanical Installation
<br />
<br />.,
<br />
<br />'...! )'..;.
<br />
<br />(:AS
<br />
<br />ROOPDiO
<br />
<br />S:PECIALTr
<br />Other
<br />
<br />PIIIISUBD FLOOIt ELBYAnOJiS:
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<br />"
<br />Rl9ck, -F~
<br />
<br />Stee.l
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<br />PT.
<br />
<br />,: IS PROJEct Df FLOOD ZON2 ~T
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<br />/0 ,:,,1'1
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<br />eee~~;.!'..a:......,....~..*...*.*..*.*..*.*._**
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<br />YES
<br />
<br />NO
<br />
<br />.'.; ; " .CONTRACTOR S!CTTOtl
<br />. "'. ,.: " ." "f";;94E AlL#JI1
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<br />::: . "ZlI.6Uk..' ,..', , S ~ ~=-r:~i:" t '
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<br />RLRCTI\lCJA/i r f;~~;,/:,_, .., ,'. :e~~t. :~::-~~t -;'~~;'~Y'l7
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<br />Sl~tu,.., d&-'~ City Lieeoaelleaiatratloo t <<03'7'
<br />-
<br />*...*..*.**-*.._...*-****..e._..**..*.*._*
<br />
<br />
<br />PLUHREll
<br />
<br />Si.8Daturl~
<br />
<br />", .d I COMPANY .
<br />State Cut. or 1leaist. ,
<br />City License Registration .
<br />***:*..**.........*......*.....*..*.**.*****
<br />
<br />HECHAm:~u.
<br />
<br />'. ~,.;:.
<br />
<br />Si.8Daturl~
<br />
<br />, " COKPAIlY.
<br />State Cert, or Regist. .
<br />City License Registration.
<br />e*......a.._.*...*.............*....*....*
<br />
<br />OTHF.R
<br />
<br />*.*a**..****.**~
<br />
<br />COHPAHY
<br />State Cert. or Regist. .
<br />r.~ ''F License Registration .
<br />~**.***......*.***.**
<br />
<br />Signature
<br />
<br />APPLlCAT10B APPROVED BY
<br />
<br />PERKIT OFFICER.
<br />
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