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<br />APPLICATION lR PERMIT <br />CITY OF AZEPIL.JUIILLS <br />BUILDING DEPARTMENT <br /> <br />1 <br /> <br />~/'i~'1'7G (j,tlf.. <br />~. ,-jJ If1Cf5 <br />/1J11(J11 . "'0 r <br />PHONE 7 g' J -- <fLY ~ y' <br /> <br />OWNER'S NAnR t{1 V IJ21g AA' "'- us;? <br />OWNER'S AUDRESS d II ~ <br />~~ <br /> <br />~ <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />:- <br />~ <br />c,'.,....,...'''._/ ~C?- ~~ A!~ <br />WORK PROPOSED:_New Construction _Addition <br /> <br />SUBDIVISION <br /> <br />_Sign <br /> <br />_Move <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br />~Alteration ____Repair ____Install <br />____Demolish <br /> <br />PROPOSED USE: ~ingle Family <br />____Commercial <br /> <br />____KIF <br /> <br />____1~ of Units _M/H <br /> <br />____Indus t . <br /> <br />_Swim. Pool _Other <br /> <br />BUILDING SIZE: <br /> <br />_Restaurant & <br /> <br />~~ <br />x~, <br /> <br />Health Department Approval <br /> <br />2~ <br /> <br />~ <br /> <br />~ <br /> <br />---- <br /> <br />~ ~ /..~ <br /> <br />DESCRIPTION OF WORK: <br /> <br />\ <br /> <br />8' <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTAL11 (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />X' BUILDING <br />(.~ELEL~RICAL <br />____MECHANICAL <br /> <br />1)0 <br />$ ~--e?I?; Valuation of Total Construction <br /> <br />AMP Service Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />~LUKBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _FrOle ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br />COMPANY)<' ~ O~~'-- <br />, <br />State Cert. or Regist. t <br />City License Registration I <br />****************************************** <br /> <br />~ELEGTRIC~) //':' . COHPANY ~(~ lU'7IL/l ./ <br />";=~ur.vff(~J.~ ~~~~\~~~~. o;.:~:~:~~i:n t <br /> <br />****************************************** <br /> <br />BUIIJ)ER <br />Signature\' MtlAa-.. €k~ <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration # <br />****************************************** <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration t <br />****************************************** <br /> <br />OTIIER COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration # <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />