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<br />_Block
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<br />APPLXCATXON FOR PERM1T
<br />CITY OF ZBPIIYBHXLLS
<br />BUILDING DEPARTMENT
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<br />ADDRESS
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<br />OWNER q / J 0 ~
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<br />JOB LOCATION 38 '-l &(p ~Qu) ~ 1 A-0L
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<br />LEGAL DESCRIPTION: LOT(S)~ BLOC~
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<br />PARCEL 1. D. 4~ :L -;1...-" -- - C50 r6 - 06 00-
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<br />APPLICANT
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<br />......
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<br />LOT SIZE X
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<br />AREA
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<br />SUBDIVISION
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<br />G
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<br />WORK PROPOSED :_New Construction -^ddition -^lteratiolitf" ~epair
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<br />_Sign/Temp.
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<br />_Sign
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<br />,:ii,{,U ; ~,.
<br />, _Move
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<br />PROPOSED USE: ____Single Family
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<br />.--.J'I/P
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<br />_~ ofUnit.,*,
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<br />____commercial
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<br />......;..;..:.;In.ciu.~ i ~ . ,...........Swim . ~oo l,>
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<br />~estaurant << Health'Deper,tJlen.tl -Approval \.' ~\."
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<br />BUILDING SIZE: X Square Feet. .;
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<br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLAN~<< (1)
<br />'COHMtRCIAL : h ATTACH- (3) SETS. OF ..BUlLDJ:NGPLAIlS..4. {l)-SB't-.
<br />**COpy OF CONTRACT REQUIRED.
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<br />_BUILDING.
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<br />$
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<br />PF.1Pf'TTS RRQJ1~STED ,~
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<br />Valuation of ,Total CQP,$~J.Mction
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<br />~ECHAN~CAL
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<br />AMP Service Florida pq~fj;,.~rp.
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<br />GAS ROOF~~G tALTY
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<br />~ELECTRICAL
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<br />_PLUMBING
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<br />TYf~ Of CONSTRUCTI9N:
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<br />_f.li~e _Ste~l
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<br />FINISHED FLOOR ELEVATIONS:
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<br />FT.
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<br />aU1TIDE~
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<br />?ign~~u~e
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<br />Sign~t'H:e .
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<br />, COAlpany ..-
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<br />. City Lis:.nlieRe~U~$tctft 4t
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<br />-,.;,,~pany
<br />. , state Cert. or
<br />CityLtcenseReg~,
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<br />E1.ECTRTCIAN
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<br />Sillnar-ure
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<br />PT.1IMIW~
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<br />. MECHANICAl.
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<br />Signature
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<br />OTHER
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<br />. KDc7-h V'-O~ .
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<br />Signature
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<br />,APPLICATION APPROVED BY
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