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<br />APPI~ICATI0N FOR PEItH.IT <br />(HTY OF ZRPUYRlIlLLS <br />BUlI.DING DRPAR1'HENT <br /> <br />OWNER'S NAH"'---~t14l_~Q.CL-_ PRONlI. 7g3 _ flfSz- <br />OWNER' S AlI01tIl!lS3Jj"lO~.i:JJJJ.s... fi Jtl ' <br />JOB AlIDRESS_a. &:ff:, 10 --.GLJrn OJU. J. f}tf ~ 7 ~ .t:Jfl!pe.li:il!:::. fid1.; ____ <br />LEGAL OESCRIPTIoN: LOT(S) 1?'iI BWC,,- _SOBOIVISION 8LfJ/J~ d/io-txt. ~ <br />PARCEL 1. O. .~ - ).) - 00511.:' OOQOQ:-I2$~ (OOTAI. 'lION POOP1\R'I:I TAX .OTl"ll <br /> <br />WORK PROPOSHD:~New Construction ----..Addi tion --.Alteration -Jtepair _Install <br /> __Sign --1fove _De.ollsh <br />PROPos,m USE: _l.Sine.le F8IIUy __H/F _, of Units _M/H <br /> __Cow.el'chl __Indus t , _Swi.. Pool _Other <br /> <br />_RestaUl'80t , Health Department Approval _ <br />(0 1(P'--J-,lb' 'I- '1'1- ,!-oil S6i!P <br />DBSGRIP'!'lON OF WORK:_ColtJCJ2.L~ 564-h(2J __ <br /> <br />BUILDING SIZE: __ <br /> <br />~"'----_.- <br /> <br />_Square Feet. <br /> <br />RESIDENTIAL: <br />COMMERCIAL <br /> <br />Beight <br /> <br />ATTACH (2) PLOT PlANS, (2) SETS OF BUILDING PLANS & (1) SE'r ENF.RGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMs. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOQESTIQ <br /> <br />t. /SCJfJ. ()O <br /> <br />Valuation of Total Construction <br />- <br /> <br />_BUILDING <br /> <br />-RLEc..'1'RICAl. <br />--...-liEGHANlCAL <br />__PLUH.~ING <br /> <br />-------AHP service <br /> <br />__Florida Powet' COt.p. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Valuation of ttecbauical Installation <br /> <br />~_GAS <br /> <br />.,RooFING <br /> <br />-_SPECIAL'!'Y <br /> <br />FUUSllEb FLOOR ELEVATIONS: <br /> <br />TnB OF CONS1'R\JG'fJON: ___Block _FrQe ~Steel <br /> <br />_Other <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />....................................*..... <br /> <br />YES NO <br /> <br />- <br /> <br />GONTRA(''"IOR SECTIQli <br /> <br />IUI.1LDEa , COHPAN~~{)IJ CoN~1fz:. <br />~/l Ii ~ State Cer<. or Reaiat. f 08'1 ~Z-- <br />Signature ~L..1..-. City License Registration' I"~R'" <br />*. ....................................... <br /> <br />ELKC'l'RlCWi <br /> <br />Si"n",tuce __ ~, <br /> <br />COMPANY <br />State Cert. or ReSist. . <br />City License Registration' <br />..............................*........... <br /> <br />- <br /> <br />[>>LUM8~ <br /> <br />COMPANY <br />Stale Cert: or Reaist. f <br />City License Registration' <br />..................*..*.................... <br /> <br />.. <br /> <br />lignature ___. <br /> <br />lEGHAN I GAL <br /> <br />:ignature _.___ <br /> <br />COMPANY . <br />State Cert. or Regist. , <br />'City Llcense Registration f <br />.***...***........*.**..*.*.*....*......*. <br /> <br />!IJIQ <br /> <br />,ign9tun~ __>_~,.___ <br /> <br />COHPANY_ <br />State Cert. or Reglst. . <br />- --"- City '~icen8e Registration' <br />**......................*.........*....*** <br /> <br />-,- <br /> <br />-- <br /> <br />Pl)UUATION APPROVE., BY <br /> <br />PBRHIT OFFICER. <br />