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<br />OWNER' S RAHK <br /> <br /> <br /> <br />OWNER' S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIP'l'ION: <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' / (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:~W Construction ----^ddition ~teration -..Jlepair _Install <br /> <br />PROPOSED USE: <br /> <br />_Sign <br /> <br /> <br />~le Faaily <br /> <br />--..Kove <br /> <br />->>eaolish <br /> <br />---.Jtl F <br /> <br />_' of Units <br /> <br />---.Jt/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />--Restaurant 5: Health Departaent Approval l.. ."\ <br /> <br />DESCRIPTIOII OF WORlt: ,-Sc;V'e~ ~ODM (Evt~f/r1j (~V\.Q.j/Lte~ <br />BUILDIRG SIZE: d ~ ?)'. 17 & Square Feet. 21 Height <br /> <br />RESIDEIITIAL: <br />COMKERCIAL : <br /> <br />ATTACH (2) PLOT PLAIIS 5: (2) SETS OF BUILDIRG PLANS 5: (1) SET ERERGY FORMS. <br />ATTACH (3) SETS OF BUILDIRG PLANS 5: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~LDIRG <br /> <br />$ <br /> <br />. __ oCJ PERMITS REOUESTED <br />J9gS --- Valuation of Total Construction <br /> <br />RT.RC'l'RICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---llECIIAlIICAL <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />~UHBIRG <br /> <br />GAS <br /> <br />ROOPIRG <br /> <br />SPECIALTY . <br /> <br />TYPE OF COIISTRUcnON: _Block _Fraae _Steel <br /> <br />Other <br /> <br />PInSIIBD FLOOR. ELEVATIOIIS: <br /> <br />FT. <br /> <br />IS PROJECT I.R FLOOD ZONE AREA! <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />RIITT.DRR <br /> <br />~f4 <br /> <br />CONTRACTOR SECTION <br />" " . I I <br />. . .~CUfpMlr Y5 t.J. i/1UrY\ <br />State Cert. or Regist. . eD <br />'tJf i?t1 City License Registration . <br />.......................................... <br /> <br /> <br />Signature <br /> <br />RT.RCTRIClAIi COHPABY <br />State Cert. or Regist. . <br />Si-ture City License Registration . <br />.......................................... <br /> <br />PLUMBER COHPAIIY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />IlECIIAlU.CAL COHPAIIY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />OTRRR COHPAIIY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />