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<br />APPLICAnON FOR PEBKIT <br />CITY OF ZEP11YR11ILL5 <br />BUlLDIHG DEPARTKENT <br /> <br />qA1-U'-- /"f-;2 -1~ <br />9- <br /> <br />OWNER'S NAItE <br /> <br />JAL~e. <br /> <br />~ L~IJ' ~~ <br /> <br />jO~ ST <br />11- <br />10 ST. <br /> <br />Htll:Hr- <br />L:E.PH'f lZ..1-t I LLs.. <br />ZE.PtN 12.1-1 f l.1...S <br /> <br />PHONE <br /> <br />OWNER'S ADDRESS G II S <br />JOB ADDRESS ~ , I S <br /> <br />FL <br />FL <br /> <br />(81~~) 788:- q99 ~ <br />33S4b <br /> <br />33540 <br /> <br />LEGAL DESCRIP'l'ION: LOT(S) <br /> <br />65 <br /> <br />BLOCK Z SUBDIVISION IYSotJ's. ~ L.Lb <br /> <br />PARCEL I.D.' 02.2b#2-I#(j08.0 -002,00 -o3S-0 <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction ~ition --.-..Alteration ~pair _Install <br /> <br />_Sian <br /> <br />~ve <br /> <br />->>eaolish <br /> <br />PROPOSED USE: 4siogle F8Ilily <br />_ec-ercial <br /> <br />---1I/F _' of Units ---1I/H <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />___.Jtestaurant & Health Departaent Approval <br /> <br />DESCRIPTIOII OF WORK: l~~"'D (){LSTh..IC, l)Q.,,/f,t.v!\.'1. fulZ.....HS,H CAR..?oR.r <br />MNC to... <br />BUlLDIHG SIZE: 20~11o X 30u.""'<:I Square Feet. 7'& ,1 Height <br /> <br />RESIDBIITIAL: ATTACH (2) PLOT PLAIIS & (2) SETS OF BUlLDIHG PLANS & (1) SET ENERGY FORMS. <br />COttKBRCIAL: ATTACH (3) SETS OF BUlLDIHG PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />-22..BUlLDIHG <br /> <br />$ 3,7:15, 00 <br /> <br />Valuation of Total Construction <br /> <br />RT.RCTRICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---.JIECIIAII1CAL <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />~UHBIBG <br /> <br />GAS <br /> <br />ROOFIRG <br /> <br />SPECIALTY . <br /> <br />TYPE OF COIISTB.UcnOIl: _____lock _Fraae _Steel A/...Um.s PEe - <br /> <br />Other <br /> <br />FIRISHED FLOOR ELEVAnOIiS: <br /> <br />FT. <br /> <br />IS PROJEct IN FLOOD ZONE AREA? -E- <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRActOR SECTION <br /> <br />. <br /> <br />JlllII"'llll .. .. '.' .. . aiHPAU--LUl W;A' (/l Al :t ~~~J11 ~ <br />A-JJ PMSo IV ~L ~ I j.j eState Cert. or Reaist.' J2.. 0 \" <br />Signature ~../ J . a ./ ) ./~ City License Reaistrat. ion . I }5" I?: . <br />.... ... ................................ ' r <br /> <br />RT.RCTRTCIAII <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration' <br />.......................................... <br /> <br />SignAture <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or ReSist. . <br />City License Registration . <br />.......................................... <br /> <br />IlECllANICAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />COHPANY fj, M OE~ O,J A LU~ IN l..L Il.--L <br />State Cert. or Regist.' R~DOS-S03\ <br />City License Registration' / K",/3 <br />................................*..*....*. < <br /> <br />Signature <br /> <br />OTRRR <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PDKIT OFFICER. <br />