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<br />APrLICAttOlf POK rQKlT ' ,'j;:~
<br />CITY 0' UPHYIJIItLS
<br />BUILDING DErARTHENT
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<br />OWNER
<br />JOB LOCATION &~~ ~'\t\ ~~~ :Z.\\.
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<br />LOT SIZE
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<br />LEGAL DESCRIPTION: LOT(S)
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<br />BLOCK
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<br />SUBDIVISION
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<br />PARCEL I.D.4~
<br />WORK PROPOSED :_New Construction --Addition ~lteration:! --Repair,
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<br />_Sign/Temp.
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<br />_Sign
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<br />PROPOSED USE: ____Single Family
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<br />~commercial
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<br />_Restaurant & Hea:lth'Depar<t1lentt Approval"
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<br />BUILDING SIZE:
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<br />x
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<br />Square Feet,
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<br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGlt'
<br />COMME:RCIAL : . ATTACH (3) SETS, OF,-BUILD.I.NG,PLANS,&- (l) ,SET ,Etff:ll~1'f'O~. *~
<br />"COPY OF CONTRACT REQUIRED. '''I '.!)'.
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<br />PF.~~1TS RF.QUESTEQ
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<br />V~fua~ion of To~a~ C~n.~~~ction
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<br />~ELECTRICAL
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<br />AMP Service
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<br />Flofida pq~~r~rp.
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<br />_MECHANICAL
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<br />_PLUMBING GAS.."..ROOFING" ".jE~7ALTY .
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<br />TYl>,E OF CONSTRUCTION: ~a+ock _~~~e _~te~l l'I'H,:",~'r"" OtheJ;
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<br />FINISHED FLOOR ELEVATIONS: FT. ' .#'.;,
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<br />. . I CONTRAcroR ~E~TlON ,\
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<br />BUF,DER
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<br />ELECTRIpAN
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<br />PLUMBE~
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<br />Signat~f.e
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<br />. MECHANICAL
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<br />Signature
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<br />Signature
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<br />APPLICATION APPROVED BY
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