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<br />A~~~~C~~I~:p~~~I~~~IT 0h.- /)11-7-C;1#7t?~ ~ <br />BUILDING DEPARTMENT ~;\ t1f~ <br /> <br />OWNER'S NAME Mt'-OC CtJ 51..;y~ {~Jjjr-c,d- PHONE ~(3 - 780 - /7/D <br />OWNER'S A()DRESS (jA.M> ,~I fltJlt 21''1~ihJ /J.."et... J!SYO <br />JOB ADDRESS ~ 73 J ft.,1L t,j.., /k~ hp)J,I.,l!J I 4r'~ $ 53''1/ <br />LEGAL DESCRIPTION: :OT(S) / Z BLOCK SUBDIVISION 5)/~ ~ <br />PARCEL LD.t [)1> - 2~ -7/- t;/~ - tJOvDO - "/2-D (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:~New Construction ____Addition ----Alteration ____Repair ____Install <br /> <br /> ____Sign _Move _Demolish <br />PROPOSED USE: XSingle Family --"IF - tt of Units _M/H <br /> _Colllllercial _Indust, _Swim, Pool _Other <br /> <br />DESCRIPTION OF WORK: <br />BUILDING SIZE: ~ <br /> <br />_Restaurant & Health Department Approval <br /> <br />~/tj 1- ~~'7 /fo~ <br />. C'1 '7"'1,'1 0' lJ II>/~ LA- <br />X......2..-1.-, v:7 1 Square Feet, 1:) 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 />4BUILDING <br />.)( ELEL7RICAL <br />4-ttECHANIGAL <br />KPLUKBING <br /> <br />$ 7t)j ~DO./ <br />ZOO <br /> <br />Valuation of Total Construction <br /> <br />AttP Service <br /> <br />x- Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />3000 .- <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />X. ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ~Block <br />FINISHED FLOOR ELEVATIONS: 0/ I <br /> <br />____FraJAe ____Steel <br /> <br />Other <br /> <br />YES <br /> <br />k <br />NO <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />.........**********.**...**.***.*.****.*.* <br /> <br />BUILDER <br /> <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration . <br />*.**********************..*.************* <br /> <br /> <br />OTHER <br /> <br />:::::1AN ~ ~ COMPANY <br />, ~ State Cert, or Regist, # <br />u eX: I ~ City License Registration # <br />. \J .*****.**********************************. <br /> <br />&~C~~ ~m~~ /~_ V' <br />State Cert. or Regist. t eFc6~~ <br />City License Registration , ~ <br />******.************.*********************. ( , <br /> <br />t1ECHANlCAL ~~ ' COMPANY ~'o~ I} f)>;',,<Jj) ~h-" / <br />'y VVI~L:'" d State Cert. or Regist, # f.../M.. (}l>fJ z.y / ~ /)1)/8 'II-I <br />Signature ~ r' -)v7~ City License Registration' ~ <br />' *...*...**********.**.***..*.********.**** <br /> <br />~ <br /> <br />~"'- <br /> <br />FIJ.;.L <br /> <br /> <br />/. <br /> <br />PLUMBER <br /> <br /> <br />COMPANY <br /> <br />Signature <br /> <br />Signature <br /> <br /> <br />COMPANY <br />State Cert. or Regist, # <br />City License Registration # <br />***...****....*****.*****..****.*********. <br /> <br /> <br />D~~17W <br /> <br />APPLICATION APPROVEU BY <br /> <br />PERMIT OFFICER. <br />