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<br />APlIL1CA'l'lON FOR IIEIUIlT
<br />CITY OF Zl!lIIlYlUlllJ.S
<br />BUILDING OEI'AHT/'IENT
<br />
<br />i\PPLlCANT
<br />
<br />/}CE ItLt1fr>,
<br />
<br />WIlRESS 31S't.fs plJJ..P) (}.ROtlc ,0/2_
<br />OHNER J:)LL-EP /YIIL. E.s
<br />Jon l.OCATIO~r~t/ ttJ36 ~//)CE WilY J)~.
<br />
<br />PHONE
<br />
<br />7P.;}-c2,"/~
<br />
<br />,
<br />
<br />1.0'1' SIZE6.Lx/lIt/ AREA SQ.l-'T.
<br />
<br />79,<
<br />
<br />U:G..'I. DESf-RIPTlON: LOT(S)
<br />
<br />BLOCK
<br />
<br />SUBDIVISION
<br />
<br />PARCEL I. D ./1
<br />
<br />-1'-.;11, -~/ -b1/st'j -~tP-LJ.;JIfL)
<br />
<br />\WRK PROPOSED:_New Construction _Addition _Alteration _Repair V-;nstall
<br />
<br />_Sign/Temp.
<br />l'lWPOSEO USE; vS Ingle Family
<br />
<br />_Sign
<br />
<br />_Hove
<br />
<br />_Demo 1 ish
<br />
<br />_H/F
<br />
<br />_IJ of Uni t5
<br />
<br />_~I/II
<br />
<br />_Commercial
<br />
<br />_lndu6t.
<br />
<br />_Swim. Pool
<br />
<br />Olher
<br />
<br />_Restaurant & Health Department Approval
<br />
<br />IIlH \.In NG SIZE:
<br />
<br />7 ~,
<br />
<br />a
<br />
<br />Squlll'e Feet I
<br />
<br />9T~ ?'
<br />
<br />,lie i gh I
<br />
<br />IU:SIDENTlAL: ATTACH (2) Pl.OT PLANS & (2) SETS OF BUUDING 1'l.ANS & (1) SET ENERGY FORtiS."
<br />coUm:KClAl.; ATTACIl ()) SETS OF UUIUllNG l'l..ANS & (l) Sl::T EtH::RGY l~OIUlS."
<br />.~COPY OF CONTHACT REQUIRED,
<br />
<br />ffRMITS REQUESTED
<br />
<br />.,.-/
<br />_UlJTLDTNG
<br />
<br />$
<br />
<br />/e2t>O,oo
<br />
<br />Valuation of Totul Construction
<br />
<br />_El.ECTRICAL
<br />
<br />MIl' Service
<br />
<br />Florida Power Corp.
<br />
<br />__\l.R.E.C.
<br />
<br />_MECIIANICAl.
<br />
<br />$
<br />
<br />Valuation of Hechanical Installation
<br />
<br />_1'l.lI/'tBING
<br />
<br />GAS
<br />
<br />ROOFING
<br />
<br />SPECIALTY
<br />
<br />.
<br />TYPE OF CONSTRUCTION; ____Block
<br />
<br />____Frame ____Steel
<br />
<br />ALUm,
<br />
<br />Olher'
<br />
<br />fINISl\ED fLOOR ELEVATIONS: FT.
<br />
<br />, ,
<br />..........................................
<br />
<br />Slgnoture
<br />
<br />I1cE rlLM/1'),
<br />~--L.:--
<br />
<br />CQNTRACT{lli 5EG.TliUi
<br />Company /S1LE 8J,...L/M
<br />Stare Cel"t. or Regist. /' ~c..o :?o/bP'O
<br />City License Registl'ution /I /60
<br />.......r.........*.*....~.........~....*...
<br />
<br />.\ll! lLU f' R
<br />
<br />~LI::GTRTCTAN
<br />
<br />Siunal~re
<br />
<br />Company
<br />Slate Cerc. or Regist. a
<br />City l.icense Registratlon U
<br />...~............*................*'*......
<br />
<br />Company
<br />State Cert, 0' Regist. a
<br />City License Registration I~
<br />..........................................
<br />
<br />fLmlllEH
<br />
<br />~~knature
<br />
<br />UI;:CllAtUCAI,
<br />
<br />Company
<br />Slale Ccrl. ur Reuibt. U
<br />City License HeaistnLtioll U
<br />............**..................~....~....
<br />
<br />Signutul'e
<br />
<br />S i gria ture
<br />
<br />Company
<br />Stale Cert. or Regist. a
<br />City License Registration II
<br />
<br />OIllER
<br />
<br />...\I\i,'.,'r..'.~;:.-" ':".,;""', :". -. "-:,,7;,: 'A,~-,.~""'."
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<br />.t..l._ "~7
<br />
<br />
<br />I'ER~llT OFfICEK.
<br />
<br />APl'l.1CATlON APPROVED BY
<br />
<br />~ .... MUJMT.
<br />,;l> '!'4 ~ mille
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