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<br />OWII8R'S _ ~ <<t~ .&Jk <br /> <br />OWBER'S ADDBBSS ' /.9~ 51 ~ ~. /?~ <br />JOB 'ADDRESS -37 / '/ R" Cd ~ ,;g:;,,"-/, <br /> <br />LEGAL DESCRIP'l'ION: LOT(S) grJ BLOCK SUBDl:VISl:ON.t~ ~i:S <br />PARCEL 1:.D.# 3 -{),-;)./ - <::J/(,'O-a:;ooa _()<gQfJ <br /> <br />PHONE <br /> <br />- fO- t. bY. <br />1) , <br />/3.i7\~, 1'0, n , "_ 17 <br />'-11''0 II/J'J- <br /><:j '7 /- ')~U <br /> <br />,... "'- t'. <br />-"TA;3A4 FL"7'1 <br />. <br /> <br />APPLICATION FOR PERKIT <br />CITY OF ZEPIlYRIULLS <br />BUl:LDING DEPAR1'HENl' <br /> <br />,'t', '" <br /> <br />WORK PROPOSED~ew Construction --...Addition ----.J\1teration <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />, . <br />---Jtepair ~Insta1l <br /> <br />_Sign <br /> <br />PROPOSED USE: )( Single Fa.ily <br /> <br />----..Kove <br /> <br />---Peaolish <br /> <br />----..KIF _, of ,Units ----..KIB <br /> <br />_~ercial <br /> <br />_Indust. _Swia. Pool ,_Other <br /> <br />-3es7t; Rea1th Departaent Approval <br />DESC1UPTIOR OF 1ilIJlK: + :i::~ A.A..-- <br />Bu:tLDING SIZE: X Square Feet, Height <br /> <br />RESlDEHTIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF Bu:tLDING PLANS &: (1) SET EBERGr FOIHS. <br />COHKERCUL: ATTACH (3) SETS OF Bu:tLDING PLANS &: (1) SET ENERGY FOBIIS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSl'RUC'l'ION. <br /> <br />PERHITS REOUESTED <br /> <br />RI.RcnuCAL <br /> <br />$ x~ $~ <br />/SO <br />$ '3SCJe) <br /> <br />. '11 <br /> <br />--..Bu:tLDING <br /> <br />AIIP Service <br /> <br />Valuation of Total Construction <br />X~l.orida Power Corp. <br /> <br />....... <br /> <br />W.R.E.C. <br /> <br />----..KECllANICAL <br /> <br />Valuation of Mechanical Installation <br /> <br />--YLUHBIRG GAS $~"te ROOFING <br />TYPE OF COBSTRUcnON: Y Block _Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />.FI.RISBED' FLOOR ELEVAnONS: <br /> <br />FT. <br /> <br />:IS PROJECT :IN FLOOD ZONB AREA? <br /> <br />.......................................... <br /> <br />YES 0 NO <br /> <br />BurJ.n~ <br /> <br /> <br />CONTRACTOR SECTIO~' <br /> <br />OIIIPAIIY ~ ~ ~JfVJ <br />State Cert or Regis. # <br />City License Registration' ~ /9. Q <br />.......................................... <br /> <br />~' <br /> <br />Signature <br /> <br />RI.~CTR:ICIAH COMPANY .:;;r .s FLee 7Jt Ie <br />~ ~ Stste Cert. or Reaist. . <br />SiDnAtur '..J- ' City License Registration 0, <br />. ........................................ <br /> <br />..fae> <br /> <br />~ <br /> <br />PLUHB~ <br />Signature <br /> <br />J.. COHPAIIY <I~~D.v.., T~~~ <br />a ~ .. State Cert. or Regist. , <br />City License Registration , / ~ ') <br />~, ....... . ................................ -. .. <br /> <br />COMPANY fJ. ~ c- A ( L <br />State Cert. or Regist. f C-ACb3~l..ftf'), <br />City License Registration, ~(13 <br />.......................................... <br /> <br />~ <br /> <br />HECIIAHT~ ,../') /J I (J) _ r- <br />Signature ~~ <br /> <br />~'- <br /> <br />OTRP.R COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration , <br />.......................................... <br /> <br />APPLl:CAnON APPROVED BY PERHIT OFnCER. <br /> <br />.' <br />