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<br />APFL.lCA1'lOIlU fOR FItRJUT <br />Cl lY Of" ZItPIIJRIII LLS <br />BUIlD ule UEPARJtIItIIT <br /> <br />:>, #1 m Eft-- JIll ~lt / IcIe "5 <br /> <br />OWNER'S ADDRlrSS 2.509 {<us ,.Ie... D/t-fC..-S DLJ-1/e <br /> <br />.JOB ADDRESS <br /> <br />502Cj <br /> <br />11 EMoR.. V <br />I <br /> <br />L/l-rJE <br /> <br />ftlONE RI;; ~1.-~~ 7S3 <br />, <br /> <br />LAt72 , fik 3'3S-4-7 <br />, <br /> <br />2~1/ f.yiLht / Is ~ Ii <br /> <br />33S--;lO <br /> <br />OWNER'S NMB <br /> <br />U;('.AL DRSCRIPl'IOIlI: WI'(S) LI- <br />PARCEL I,)).' .:;;;; ~ M.etZ... ;..4 /1 ~ 4 <br /> <br />RIA)(.."K <br />I)/I/'/S' "tn./ <br /> <br />SURDIVISIOIl <br /> <br />S;~Mer d// <br />4L'~ l l/6 -/7 <br /> <br />WORIt PRoroSItD:~lIev Construction ---.J\ddition _Alteration -....Repair _Install <br /> <br />/;l~~6 -dJ./ <br /> <br />_Sign <br /> <br />_J!tove <br /> <br />_))e-.olish <br /> <br />PROPOSED USE: Y Single F,.i1y <br /> <br />_"'f' <br /> <br />-1-, of Unit.s <br />Lswu.. Pool <br /> <br />-"In <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />Other <br /> <br />___estaurant 5- Dealth DepartlM!'llt Approval <br /> <br />BUILDING SIZE: <br /> <br />1ft, X ~ h , <br /> <br />J 110 <br /> <br />~uare Feet.. <br /> <br />I~/ <br /> <br />Height <br /> <br />RESIDENTIAL: <br />eotmERCIAL : <br /> <br />A1TAm (2) PLOl PLAlIS 5- (2) SEIS OF BUlIJ)IIIG PLANS 5- (I) SET EIIERGY FORKS, U <br />ATrAaI (3) SETS OF BUILDING PLANS 5: (I) SlIT EIIERGY fORtIS..... <br />..WPY OF WNTRACf ,RlfQUI.RIlD. <br /> <br />/ <br />_BUILDING <br />l.--"'/ RLEt.'TRI GAL <br />~ HF.(;DANlGAL <br /> <br />PllmtlTS REOUESTJID <br /> <br />So <br /> <br />1~ &7t:J~ <br /> <br />Valuat ion of Total Constnlction <br /> <br />dt9<J AftP Service <br />f'd~oo. ~ <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C, <br /> <br />$ <br /> <br />Valuat ion of Kechanical Installation <br /> <br />v-- ____ <br />_PLtJPtBING GAS .ROOFING <br /> <br />lYPE Of' WNSTRUcnOIl: --=::B.lock _Fr~ _St.eel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIOfIS: Q'1 FT. <br /> <br />IS FROJIl:CT IN FLOOD WRit AREA? <br /> <br />"..-/ <br />YES NO <br /> <br />...................................................................................... <br /> <br />BUIIJ)ER <br /> <br />QJIIII'IKAClUR. SEt."I'.lOIl <br /> <br />(DtpANY 7;A-~ #,e,e/s <br />State Gert. or Regist. , <br />City License Registration , <br />........................................................................................ <br /> <br />CG-c.. O/~9/7 <br />* ~t:J / <br /> <br /> <br />WlPIf'ARY 51-1E pjJ~ / Ekc-ht.-/c <br />State Cert. or Regist.' 6 fl (H'IC,\CY3:./S <br />City I.icense Registration , dt06 <br />................................................................................ <br /> <br />PIDIBER k OOPIPARJ J4~m~".I 771/kL-eK... <br />- / / I I State Geet. or Regist. , <br />Signature k ~ Cit.y License Registrat.ion . <br />, .................................................................. <br /> <br />/5'S- <br /> <br /> <br />OOPIPARY :5Yej9/J~1 g.ec-~'c <br />State Cert. or Regist.' C Uc..<.J'-\ \(5) 6 <br />Cit,y License Registration , // / <br />.......................................................................................... <br /> <br />,.-~~ """'AIIr J,L'd t:./, -{ <br />, StaLe Gert, or Regist. . U KQ. C)OCo\ lo'f~ <br />'-.,-.. , City License Registration , .5'eJ <br />............................................................... <br /> <br />SignaL <br /> <br />. <br /> <br />APPLICAY.lON APfROVED BY <br /> <br />PERIIlT OFFICER. <br />