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<br />APPLICATIOJ!ll/ FOR PERKIT <br />CI'IY OF z..twIll'KH IU..s <br />BlllLDlliIG DEPARnII!Xr <br /> <br />OWNER'S RAKE <br /> <br /> <br />co <br /> <br />. o/(l7 - 741-1; D/ [) <br />PHONE <br /> <br />OWIfER'S <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPl'ION: UJI'(S) <br /> <br />BI..OC:K <br /> <br />SUBDIVISIOS <br /> <br />PARCEL I. D. t <br /> <br />. /~ <br />. WRK PROPOSED:_lIev Construction _Addition ~ration ~ir _Install <br /> <br />S' <br />- J.gIl <br /> <br />_nove <br /> <br />_I>e.olish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />.' _KIF <br /> <br />_, of Unit:s <br /> <br />_K/H <br /> <br />_ec:-ercial <br /> <br />_Indust. <br /> <br />_Swill. Pool <br /> <br />Ot:her <br /> <br />_Rest:aurant 5: Hea11:h ~tApproval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />. RESIDENTIAL: <br />COtttIERCIAL : <br /> <br />A'l'TAaI (2) PUJI' PLAIIS 5: (2) SEI'S OF BUILDDiG PUUiS 5: (1) SET ENERGY FORMS. ** <br />ATI'AaI (3) SEI'S OF BOII.DDIG PI..O'S 5: (1) SET ENERGY FORMS. ** <br />**COPY' OF COIITRACT KIlQUIRIlD. <br /> <br />~ KEOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Tot:a1 Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ 2} ,,~(), () 0 <br />_PUJttBllfG GAS ROllFING <br /> <br />~CAL <br /> <br />Valuatim. ox Hechanica1 Installation <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUC'l'IOJ!ll/: _Block _Fra.e _Steel <br /> <br />Other <br /> <br />FIlIISlIED FLOOR ELEVATImiS: <br /> <br />FI' . <br /> <br />IS PRO.JECT IN FLOOD ZOllfE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />COJIIIRACIOR SECTION <br /> <br />81JT' .pF.R <br /> <br />COItPBY <br />St:ate Gert. or Regist:. I <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />ELECTRICIAN <br /> <br />COItPABY <br />St:at:e Gert. or Regist:. , <br />City License Registration , <br />*6&&&66*********************************** <br /> <br />SiPll::lture <br /> <br />PLUKBER <br /> <br />COItPARY <br />St:at:e Gert:. or Regist:. , <br />City License Registration t <br />****************************************** <br /> <br />g ~~ <br />/J /J * JU :=eAIIY Cert. or ;;ft~~ <br /> <br />~ ~'L- City License Registration' .:l c. r <br />( ***************************************** <br /> <br />Signature <br /> <br />Signature <br /> <br />~j~fJ. '" <br />~ ... <br />j- <br /> <br />KEawnCAL <br /> <br />0T1IF.R COItPARY <br />State Cert:. or Regist. , <br />Signature City License Regist:rat.ioo. , <br />*********~******************************** <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />