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<br />APPLlCAUOJ fOR p..x'f <br />CITY or ZIIII!III1LtS <br />IUILDDIQ DBPAIltill'lr1' <br /> <br />OWIIIR' s... /J? /Jfi Y <br />OIIIID.'S ~ '/)'it:lo <br />JOB ADDDSS .':f ?..C:;-II <br />LIGAL DBSal!PnOl: wr(s) <br /> <br />R ;./:)CJU T <br />WII-/<-INS <br />J/ ti- ~ <br /> <br />12&. <br /> <br />PIIOP (,2 t - S//3 <br />1Pfi-1 P1 ;3 36/9 <br />P( <br /> <br />...<e~ ~ II A hr ilr <br /><r f <br /> <br />B~SUBJ)lV1SIOII LLI <br /> <br />PARCEL I.D.' <br /> <br />fOBTAlI ...,. Pm'PD"I'Y Tn IOTICR} <br />II. COIuItmction -..Addition ---Alteration .....lr ~Iutall <br /> <br />W01Ut PJOIIOSID. <br /> <br />---1Jiea <br /> <br />---'loVe <br /> <br />--.D-oll.h <br /> <br />PROPOSED uu; ~taa1e P-ilT <br /> <br />_ec-erctal <br /> <br />--Jl/P _' of Unita _/8 <br />_IMuat. --Jlw~. Pool _Other <br /> <br />. hetauna.t I: Health Dep&rtaent Approval . <br />1lU~ OF _,C~rlUll fleATt*j r (jje '/A5,H... D/l..C:nJO-R-v./~)f'IL4De. <br />BmtDIIIG SUB: 30 I IS . ~II 0 tJ Square I'eet._/ <f I Beiaht ' <br />IlBSI.bBl'l"IAL: AT'l'ACII (2) PLOr PLAlIS I: (2) SITS or BU1U)IIfG PLAI1S a (1) SIT BIBRGY rolKS. <br />COIIKDClAL: AftACJI (3) SITS 0' IUlLDlIG PLAKS a (1) Sit BRBRGI' FOllIS. <br />ROnan SURVU UQUU8D POll ALL IIIW COBSraUC'l'lON_ <br /> <br />PaHI.TR RRnlJRAIftm <br /> <br />__UILDDIG <br />)CRI.acruCAL <br /> <br />~c&L <br /> <br />-JUIIIDG <br /> <br />. ~ ;:; t9-t) Valuation of Total Coo.atnctioo <br />J.,,5?:) AMP Service -lorida Power Corp. <br /> <br />If.a.B.o. <br /> <br />s . r ?rJc!. <br /> <br />Val_tion of lledL8aical Iutallatloll <br /> <br />GAS ROOnlG <br />.1~k ~u.e _Steel <br /> <br />RPBCIALft <br />Otbel' <br /> <br />nn or COISDUCflOll: <br /> <br />PUtISIIBD ROOIlILIVAUOIIS: <br /> <br />PT. <br /> <br />IS PBOJBCT U noon 2.0ft ADA' <br /> <br />YBS <br /> <br />- <br />110 <br /> <br />.......................................... <br /> <br />(l'IITIIAC'I'OR Itcnoll <br /> <br />JMtJUtR <br /> <br />OOIIPAII <br />State Cert. or Kqlat. . <br />Oit1' Lie... Reai.trat!oo . <br />.......................................... <br /> <br />S:l.....ture <br /> <br />RI.RP.I'IITlnD OOIIPAIlY_' Jc.)LT~~ ~~ <br />~ ~L--itata Cer~. or Kq1a~. . F.:f'!!fj!:f'S <br />S::I-t.ure ./ ~ ~ Cit.,. Lie... ...i8tratlon . ' <br />.. ....................................... <br /> <br />Pll." <br /> <br />OOIIPAIfI <br />State Cart. or Ileat't. . <br />Oity Lie... Reaf,8tratioa . <br />...........*.................~............ <br /> <br />COKPAlfY1l11 STctfTe fif.fk!' /l-/c. LIUC. <br />State Oert. or ..,lat. . C .~~ lfO <br />ity Lieeaae Re.lat1'ation . .II '. <br />.......................................... <br /> <br />Sipature <br /> <br /> <br />Slpat <br /> <br />ft'IlIIn <br /> <br />OOIIPAD <br />8tab cart. or Ilell.t. . <br />Olty LiceaH Reai.tratiOll . <br />.......................................... <br /> <br />Si8Mture <br /> <br />APPLICADOII AI'nOVD BY <br /> <br />PDIIIT OPnCD. <br />