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<br />APPLICATI05 FOR PERKIT <br />CI1Y OF ZEPIIYRIIILLS <br />BUILDDiG DEPARnIEn' <br /> <br />OWNER'S NAItE <br /> <br />~ <br /> <br /> <br />aAL4.~l./ <br /> <br />~ -~~ <br />/~;~ :6; , <br /> <br />OWNER'S ADDRESS . ~~ <br />JOB ADDRESS ~j7 2- <br /> <br />LEGAL DESCRIPTImi: I.OT(S) ~SUBDIVISION <br />PARCEL LD.' 1/-.:2 ~ -'2T -t)~/o. -ILj/oe:;;~.per() <br />WRK PROPOSED:_lNIev Construction ~tion _~t'r~t~ _Install <br /> <br />S. <br />- 19D. <br /> <br />_!!love <br /> <br />_Deao1ish <br /> <br />PROPOSED USE: <br /> <br />Sing1e Faaily <br /> <br />.' _fl/F <br /> <br />_' of Units <br /> <br />_K/H <br /> <br />_<=<<-ercia1 <br /> <br />_Indust. <br /> <br />_S~. Poo1 <br /> <br />Ot:her <br /> <br />_Rest:aurant 5: Hea1t:h Depar1:.en.t Approva1 <br /> <br />BUILDDfG SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />. RESIDENTIAL: <br /><XlKItERCIAL : <br /> <br />ATTACH (2) PI.OI' PI.AIIS 5: (2) SE.'I'S OF BUILDDIG PlARS 5: (1) SET EBERGY FORKS. ** <br />ATI'ACH (3) SEI'S OF BUILDING PLD'S 5: (1) SET mmRGY FORKS. ** <br />**oopy OF ooIn"HACT BIlQIITRIID. <br /> <br />~ REQUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Va1uation of Tota1 ConstrUction <br /> <br />_ELEC'l'RICAL <br />V-KECIWlICAL <br /> <br />AItP Service <br /> <br />F10rida Power Corp. <br />I <br /> <br />W.R.E.C. <br /> <br />$~t/ c> 7: c> () _.. c_ Va1uation of Kechanica1 Installation <br /> <br />_PLUKBDfG GAS HOOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF ooNSTRUCTIOR: _B1ock _~ _Stee1 <br /> <br />Ot:her <br /> <br />FDIIISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />***~************.************************* <br /> <br />COJn'KACTOR SECTION <br /> <br />BUILDER <br /> <br />CO!IPOY <br />State Cert. or Regist. I <br />City License Registration I <br />***..*****......*~*..***~*~***~***~**~**** <br /> <br />Signature <br /> <br />ELEC'l'RICIAN <br /> <br />CD!IPAIMY <br />State Cert. or Regist. I <br />City License Registration t <br />**.********.*.**********..***~.****~*~**** <br /> <br />Sismature <br /> <br />PLOKBER CO!IPMiIY <br />State Cert. or Regist. I <br />Signature City License Registration I <br />.*********..**..**...****~*********~*~**~*~ ~ <br /> <br />KECHAnCAL CD!IPAn ~ ,l)~*" <br />~ J ~ State Cert. or egist. I J <br />Signature (/-.1 ~ City License Registration I .2 D. r <br />~". *****~**.****************.********~*~*** <br /> <br />0TIIItR CUlPMiIY <br />State Cert. or Regist. I <br />Signature City License Registration # <br />****.*********..***.***************~****** <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />