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<br />;\"'fo'J.lCA'nO!lll ro. MmrfTl'
<br />t:lT1' OF' 7.F.I"RY1tRIU,S
<br />..n n n T 11(; Df!:rARnf'P.Jn'
<br />
<br />/\).10(-- uJ ,,,91
<br />'r" I '\ -!:>' I b
<br />J b "I
<br />-'- _J1J()NE_.~~. ?6 L...17S1J
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<br />P':<it''lU\' ~ HAHL..-_.&~..z:26'-,-_,2<e~--c&,?__g...9L T7.
<br />tl'Ii'IfER I fi ADDRR5S_'_h,_..2J~.e_.~.-9L.L g~p" __"__
<br />.fCJR ADDR~____.. ___ ~...s:Z~,_,_r;;/9(.4 dy.Q., .________________'_______.____
<br />
<br />I.F.cAI. DRSC'lU.PTIOII~ UJT(S),____ ._______. __"._ftl~_
<br />
<br />SUBDIYISIO",
<br />
<br />PAR(."F.T. r - n..--LL:.r;?~...:::~_L-_a~.Ul-_.CJs:_:7().O ~ Oc:;S-I__,.._,~____ _'____._______
<br />WORK PROPOSED:____ ,Jlf!V COO8tl't1Ctloo__._ftJditi ~tcrtlt:ion _R.epair Tn~tall
<br />
<br />~,,)ign
<br />
<br />___.Jtove
<br />
<br />__->>etIOl1~h
<br />
<br />mo~EO U:;B.L_~._..sin&le Faaily
<br />/('~rCltll
<br />
<br />.. ___._lf/F
<br />
<br />.__.' ot Unit..s
<br />
<br />---"I H
<br />
<br />_~_lndu.st .
<br />
<br />___.__Svi.. Poul
<br />
<br />..-----.._________, ,___,..Oth,.r
<br />
<br />-- . .RA!st8t1nmt 5 BP81 th Deper~' Approval
<br />
<br />BUILDING SIZE,
<br />
<br />..Jl_______ .________. _
<br />
<br />._Square Pt'f!t.._____
<br />
<br />Height
<br />
<br />. RP..SIDEHTlAL:
<br />COttHERC'lAI. ~
<br />
<br />it.T1'"!c'lI (2) FUJI' I'I.A~ & (2) SEJ'S OF BUILDING PLMi/S , (1) SEt' EJlF.RCY FORMS. H
<br />^IUU~ (3) SETS Of" ftUH.JJl.c I'tMS &: (1) SET ENIl:RCY FoRKS...
<br />":UP!' 01' UJH11tAcr ~.
<br />
<br />.(.8UTLDIteG
<br />L _Y.I.KCTRIGAI..
<br />
<br />PDfIlT$ RP.flUP-(:jJfJ!
<br />
<br />$. . 3'.(....3-a>27,z_L__VahUlt:;0IJ ot Tot~l r.onounirtion
<br />
<br />,--__ _ ..H_)\PIP S("YVi("'p
<br />
<br />----Y 10rida l'OWPr Corp.
<br />
<br />W.R.E.C.
<br />
<br />mCRAJflCAJ.
<br />/J'( J lt4nTI!!~
<br />
<br />,..,---_____,_____________._Va.luaUon of Hcch8nir.nl Installation
<br />
<br />____.__, ,__CA..f:j
<br />
<br />----..--- JlOUt"lltG _____..__j;PRCTAt.1'Y
<br />_.~.Frae Stfl~ 1
<br />
<br />Ot..nf!r
<br />
<br />TYPE Of (~n"nm(;,TTOII: __......B1oc-k
<br />
<br />PnrJ"mF.D YIJ,nR ItfJNAnOllS :_,__YT'.
<br />
<br />IS I"HO.JE(.'T IX 1'1.000 ZOHt.: Mtt'.A.,
<br />
<br />...........+..............................
<br />
<br />YES NO
<br />
<br />IllILnm
<br />
<br />
<br />.~!.imI_l>.&fT .lQl(
<br />
<br />CQtPAHY_C~.l~.d'QI77.a -L.H!!.:.. .6i ~~"'" ,
<br />State (:tort. or Regist. f ,.~:i.!L___.._.._._,_~
<br />City Lic('o,;r Rf!gtstration t _ /1/ 6L..
<br />.
<br />...**......e...............
<br />
<br />SjgtUltnrr.
<br />
<br />=~.~~~/~,J~-~~;~:fK-9~I'l~~...==-== t--'
<br />. -- -".-- eft:)" Licen.s(': R{"R"h;f:rotion' / 9~7 __..__.~_
<br />........~.~+.............................
<br />
<br />&tilER ~;~ /p: ~J.~~-;.4!17e,~~~1!:1.E4;zi~1~ .~
<br />
<br />SiP.natnre~. ".' ........ '''____.... City Lin,'n~f" Rr.RIr.tratiou' ----1-?-h...._
<br />· .....~............#.t.*.............
<br />
<br />D...II!trA!lfY ______ _____
<br />St8te r~CI.. 0.- Rc~ist. ',~__.__
<br />stRJ19tvre _-.__.,___'''., _.._..,...' .____., Cf l.1 Lit;l~5i!: H~~ietrat"ion f
<br />...................A......................
<br />
<br />Siaatu.ce __
<br />
<br />lI&.&U!~
<br />
<br />n.J1tJl. cotWAIn___.., ______.__. '.
<br />~t8t"E' (;Pr'-. or Rf'et~t _ ,_____,__. __,p_ ____...__
<br />!r:rVlf'llre _____.._____ _~_..______,_~.._.___ _ Cil.y J.it.'Pr)!l~ Rng1st,ration , ._"_____,_
<br />..........~...............................
<br />
<br />.VPJ.TCAno. At"hroV~' BY ______.. _____
<br />
<br />Pt:JUtll OFFICER.
<br />
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