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Date Received <br /> I a i k a a s i l Pttrino t ontai t for Poa� y f <br /> -914-�7&9 -.3�OwneYeName �!f)'ar�.t/� �C� �a tir+�. OvanerFhanef�umtrar / <br /> Ownees Address ip 1 5' 34 OwmarPluxneNumber <br /> Fee Simple TltloholderName OunerPhoneNumber { <br /> Fee Simple Titleholdar Address <br /> JOB ADDRESS id+ j tF# G ail tj�ttll�� fir .' �J 2 LOT# - <br /> SUBDIVISION �Y S O rat PARCEL ate 2—Z It txJ�O—Qa 2tx�—t7 z O <br /> 'r--— <br /> foazArVts3�assrr. xYxrx.art� utatrcr:} .. <br /> WORK PROPOSED 11KI tk5111[2 AOD/ALT Q SIGN Q Q DEF40USH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q Comm Q OTHER <br /> TYPE OF CONSTRUCTION [::J 'BLOCK FRAME �y��T STEEL ED <br /> DESCRIPTIONOFWORK <br /> BUILDING SIZE SO FOOTAGE z,AZQ45 MSC 9 <br /> '+!•Ki t ccirc <br /> =BUILDING S 10 �"',J� VgwATiONOF TOTAL com- aTtQN <br /> =ELECTRICAL 1(S � AMP SERVICE Q PROGRESS ENEPGY Q W.R.E.C. <br /> =PLUFeIBtNG � <br /> =MECHANICAL C� VALUATION OF MECHANICAL INSTALLATION <br /> =GAS F:L41 ROOFING 0 SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FL.00DZONEAREA YES NO <br /> f-J-S4 act^ eT^ES - �r �g i �+ <br /> BUILDER }--� C06`PANY t tin t-C <br /> SIGNATURE ¢ r�asrEnm YIN FE[ rt Y t.N <br /> Address �ti !} W-1VI(bgr'a Ave ME 4�ttffitcl' ,FL 3Z78+4N Lacanse# `t 2- <br /> ELECTRICIAN COMPANY <br /> SIGNATURE PEctsretm Yt.pt . FeacmieN YttV <br /> Addess License# j <br /> PLUMBER C0161PANY <br /> SIGNATURE REGISTERED YIN, RE-, <br /> Address LicenseI( - <br /> MECHANICAL. COMPANY _ <br /> SIGNATURE r¢ smnEo YIN FECWMW YIN. . <br /> Address Licatrsctfl�— <br /> OTHER COMPANY �� <br /> SIGNATURE I YIN Amru—pRix Y:t <br /> Address Ucwtse# <br /> I gifts ltlllla14121ltellifIItI1401121a4a-tielazzalwev slazzatuaTetsIC1YtCdt <br /> RESIDENTIAL Aituclt(2)Ptoi E'iirits;(2)se is of Hu#td ng Pirulr:(t)»�ofEnergy s rims,Ft O Vti f'osmll t6rnevx cwtctirsctian. <br /> N3giriium on(St)}worldng after subntfiia(' Rut uisadaus=lo,Corrwtnrr2iart dart»,StcrmuRi!am.Plnasvd S$tl ez+ci fn tetL, <br /> Sanitary FaclGtios&1 tkrmpstar,Sita Ntorit Pomiii fcr si+LafvislotrJiargd pm)acts <br /> COMMERCIAL /tltadi(2)compfila sets tit Buildtnp Plans plus a Utc Satsty Paga;(t)set of�F.-,- <br /> ,R 4 W PcxrtW forard consti4�Uvn. <br /> Ndntmrrm Ron(1e}weridn days niiur sutxal ul dal-;i#�ulrod on^+io. tamrvraSanitary Fadiillas S I duritpstor.Slta;t.ltv1,mltfajcd teitubamruds mvu meat cpmpilance <br /> SIGN PERMIT Aflaah(2)sate a EnIiin..ed Plans. <br /> ""PROPERTY SURVEY tequired for all NEW censttudtah. <br /> Directions: <br /> Fill out oppl!xullon completely. <br /> Owner&Contractor sign beck of appttcafion,noU dzed <br /> Itovor$2500,a Notice of Commencement is required.(AIC upgrades ovar#7600) <br /> Agent(fortho contractor)"Power of Aliomay(forlhe owner)would be scmeane with notarized letlerfrom owneraathadzing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroors if shingles Sewers Service Upgrades A/C Foncas(PlotfSarveytFoolage) <br /> Orivoways-Not overCounler if an public roadways..needs ROW <br />