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<br />AP~LIcArloN rOR PRRKlt <br />CITY OP ZE~nYIUI1LLS <br />BUlLDINU'bEPARtKBNT <br /> <br />/-1- 9( <br /> <br />P~R <br />OwtfEtt' tj ADbUSS -P>J.b 7 IItv f' Sf W f 5-r <br />Job ADDJt~S J...() 1 <:? f IO/Jb R..t DG-t.. w!tY DR-. <br /> <br />~ ' ; ;. <br /> <br />OWNER'S NNII <br /> <br />JU1~~'cr.ftf~ MII~of'1ts PIlONE 7f;Lr~:2?b <br />I <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEt t.b.,.} -.)t, - J/ -tJJ/()-LJcx:x:v-c:)..??/) <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />~ORk PROPOSED! ~ew Ooogttuctiun ---AddiHull ---Alteration --..Repair _Install <br /> _S1811 --1Iove ->>e.olish <br />PROPOSED USE! ~iti81e railY --111 F _' of Units -11/11 <br /> _C~erctal _Indu8t. _Swill'l. 1'001 _Other <br /> <br />--..Restaurant Ii Ilealth Department Approval <br /> <br />DESCRIPTION OF WORk: OftRAf.::;:-Iy-- <br /> <br />Pit rl 0 <br /> <br />BUILDING SIZB: ,;) 0 X .;Lv. UD Square Feet, y;'tdtJ 'lIeight <br /> <br />RESIDENTIAL: AtTAl,,. (2) pwr I'LANS tr (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COHHERctAL! AnAtll (3) SBTS or BUtlJJING PLANS & (1) SRT ENERGY FORMS. <br />,ltUPJnttt StJItVEt dQUlRED FOR' ALL NEW CONSTRUCTtoN. <br /> <br />~ILDING <br />_ELECTRICAL <br />----1f,ECllAtflCAL <br />-----YLtJtlblNG <br /> <br />PERHlTS.ItEOUESTEQ <br /> <br />. $ .;2;;2,.7J: U 0 <br /> <br />v41uatlull uf Tot41 Construction <br /> <br />NIP Service <br /> <br />Plorida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Heclutnical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUctION! '. --Block ___Fr_e _Steel <br /> <br />Other <br /> <br />FIlUSHBD FWOR ~UVATIONS:.., .Ft. <br /> <br />IS 'PROJECT IN FLOOD ZONB AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />BUIIJJER <br /> <br />~ L a.wANt. <br />stat@ Vert. or Regist. , <br />.~ ~ City License Registration , <br />.......................................... <br /> <br />CONTRActOR SECTION <br />!lU /fLtJ/11. <br /> <br />Signature <br /> <br /><:P~ <br />Ge<.O.$'/WC) <br /> <br />EI.BL'TRlClAR COHPANY <br />State Cert. or Regist. , <br />Sianatuce City License Registration # <br />....................t.....tt.ttttt.t...... <br /> <br />PLUKBER COMPANY <br />St4te Cett. or Regist. , <br />Signature C1ty Licettse Registration t <br />.......................................... <br /> <br />HEGllANlCAL COHPANY <br />State Cert. or Regist. , <br />Signature city LIcense Registration , <br />.......................................... <br />, <br /> <br />OTHRR COMPANY <br />StAte Cert. or Regist. , <br />Signature City License Registration , <br />.......................................... <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />