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<br />)\I'P'1J[('"",\'I'J:m~ Firm. p1f1,:TI:nIT <br />CJf'IT OF ZEJl'iUlR:U[ LLS <br />JIRU1LIDINJG JDilB',IPAltnm,l1ifT <br /> <br />m.."NER'S NAME q U..sS 2' LL rv1. ~ ((0 w "l <br />OWNER'S ADDRESS X:2,~5 Ht\( (t"""ELlL\ COCJ~ z..t::'PH"fRH-II LS) fL ss54( <br />S I k V ERe I iQ c L E) 'Z. E P \-t '\{ Ql-\ ILLS -r- FL 3,'35 4- I <br />stmDIV1SIO~ L 14 \1- L Fa NT v I LL t4-S <br /> <br />1'110:ilF, <br /> <br />'(?SO -I ~24- <br /> <br />,TOB ADDRF_<;S <br /> <br />41 for <br /> <br />LEGAL DESCR1PTION: urr(s) <br /> <br />UlLOCK <br /> <br />PARCEL I.D.~Cf< EeL> f2 P <br /> <br />(p L '~T (800"~ 2 q Pr1- 6:E 8 ~ <br /> <br />h"'ORK PROroSED:~CW GDJfls!~ruetion _Addition. _Alteration _Hcpair __Install <br /> <br />_Sign <br /> <br />_ItUove <br /> <br />_Dcno1ish <br /> <br />PROPOSE.D USE: <br /> <br />~nglc Pmlllily <br /> <br />---:-.nlP <br /> <br />_4f1 or Vnits <br /> <br />_~1/H <br /> <br />_CorImllcreial <br /> <br />_Indust. <br /> <br />_Swim. Pool <br /> <br />Othcr <br /> <br />_Hcstaura!lt. & Health DClP.armcn!~ l\pprovaJ_ <br />({t I 4 I <br />BUILDING SIZE:~q 0 x 4-3 8, MOD.. UN I QL)e}2~ Square Feet. '8 0<< @~ fi VE> <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COrniERCIAL : <br /> <br />ATTACH (2) PLOT PlANS li (2) SETS OF BIDJ.nUJG PIu;'",~S [< (J) S];::T ENERGY FOm'IS. H <br />ATTACn (3) SE:TS OF mrU..IDJlJ\1G l"T.AmJS [;: (1) SET E;:-':ERGY FOR!"IS.-::'O: <br />-l:-i1cCOPY OF CmfTRACT nn:.QQJi]RiID. <br /> <br /># <br /> <br />PE:TIUHTS Rf,QUESTF.:D <br /> <br />~~un.DING <br />~ELECTRIC^L <br />~fECIIANIC\L <br />VPLUMBING <br /> <br />$ 30) (")hO Valuation of Total GrmSITQlc!:ion <br /> <br />J 00 M1P Service ~Plorida POh'<P.T O:)rp. <br />.$ II DO Val1l.llat.ion of: ii'Ieehanical Installation <br /> <br />W.R.E.C. <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ~21ock <br /> <br />_Framle _SLeel <br /> <br />Other <br /> <br />FItUSHED FLOOR ELEVATlm~s: 11 IT . <br /> <br />IS PRO.H~CT IN FLOOD ZONE :\!~FX'..' <br /> <br />~ <br /> <br />YES NO <br /> <br />~~~~~~~~~~*~.~~*~~~~t**~~~~~~~**~~*~~~~~~* <br /> <br />BUILDER <br /> <br />~ <br /> <br />OOM'RACTOR Sm;.I'TOl'~ <br /> <br />OOOiPArr>JY c;< I) <; ~ (~ LL <br /> <br />Signaturc <br /> <br />fYI. 13r~ <br /> <br />SLate Cer!:. or Regis!.:. "Ii <br />Cin:y I.icense Registration <br /> <br />m. 'B (l.b Lv f\-( <br />C 6:: C O?, (., \ I <br />::' II <"") <br />i> ~'t~d <br /> <br />~~~~~~,~~~~~~~~**t~~~~~~**~~~~~~~~*,~,~~~~~~~ <br /> <br />SiRf1ature <br /> <br />~ <br /> <br />m.~~ <br /> <br />otmU'ANY 9 USSELL <br />St~Jlte Cerl:. or Regisl:. #: <br />Cit_y I.icCl1SC I~egistl~ation <br /> <br />m ~ ~ RoLv /'-~ <br />FR oolb5S1 <br />~i lfo1 <br /> <br />I-:T.ECTRICIAN <br /> <br />~~~~~~~~~~*~~~~~~~~~*~~~~~~~~k~~*~~~~~~~*~ <br /> <br />Signature <br /> <br />~ rYl, <g\.~ <br /> <br />co:?:w",\l'n 9 US.s.6 L L YV1, b aD Lv JJ.. <br />State GerL or RegisL !f.: C 1- co.3 Cf q C1 b <br />City I,iecHse I{cgist(";}(:io!1 ~i 101 <br /> <br />PLl~F:R <br /> <br />~~~~~~~~~*~~~~~**~~~~**~~~~~*~~~*~~~~~~~~~ <br /> <br />Signature <br /> <br />~.~ <br /> <br />M. ~\.~ <br /> <br />~;;0';;~'i:1" ex U SSE LL WI. ~rJLo Lv 1'-1 <br />SLat.::', CerL or RegisL. !l~ cl=l Cb 4/ Zs 4- <br />.- -J" <br />Cit.}'" J..r.ecnse Regi"tr-,;;~t:ion _-1 <br /> <br />"riEGiit\!:-ITC!\T" <br /> <br />~~~~~~~~~~*~*~~~t~*~**~~~~~~~~~~~~~~'~~~~*~ <br /> <br />00lfLrll.~{Y <br />State Cerl:. or Ite~ist_ # <br />eifel'" 'LicCIl.5C lteg,is tra [~ion i# <br /> <br />01llER <br /> <br />Signa ture <br /> <br />~~~~~~~~~~~~*~~~*~~~*~~~~~~~~*~~~.~~~~*~~*~ <br /> <br />APPUCATION APl'rmVEO BY J1..~:~ j, h\,IW- <br /> <br />. . , '; {';:~j',~'.". .;. <br /> <br />, ... -'- .\.. <br />~~. ~'.';.. ~.~:;,.,~ -,.. <br /> <br />PEmnT OFFICER. <br /> <br />~<~~~' :~,:.,:;.~~r. <br />l" .... . :.:~ .' <br />l~__ ',;-" .,.'- ,'. -~ <br />~ ."";.')~ . <br /> <br />\';;';;.~:L:.::"/ <br /> <br />". <br />