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<br />COKJc., 1"'1::- <br />OWNER'S NAMll R, 'IUS ~ f?c: q /.''i <br /> <br />\.d_U Uli L:.KPHYRHILLS <br />BUILDING DEPARTMENT <br />- <br />.....;.AJC .. <br /> <br />..,,?;. <br /> <br />"t;' <br />'," , <br />..I,i.' <br />. 'f~J' <br /> <br />JOB ADDRESS <br /> <br />~I/'L <br /> <br />~ '~'/'~J <br />. I.. - , ~ c- . ..__: <br /> <br />.\:\ <br />..,;i::. <br /> <br />OWNER'S ADDREsS _< V" l M? <br /> <br />I'd JcI~'~.~~ <br />}~t' <br /> <br />LEGAL. DESCRIPTION: LOT(S) BWCl\ S DBDIVIS ION ~..i" <br /> <br /> <br />PARCEL I. D. '3.<, :2S" .:L I Q rllll. o~ r (JOo oJ D (OIlTAI: Fl\!lll PIlOPERTY TAX ~ciilh <br /> <br /> <br />WORK PROPQSED'____New Constructioo ----Additioo ----Alteration ~sir ____~~ <br /> <br />:U,.'" <br />\'0' ',,;~: . <br /> <br />_Sign <br /> <br />--.Move <br /> <br />_Demolish <br /> <br />PROPOSED USE: _Single Family <br /> <br />.', <br />,;~,;},;: . <br /> <br />_M/F <br /> <br />/&, of Units <br /> <br />_M/H <br /> <br />.C <br /> <br />_CoIIlIlercial <br /> <br />_Indust. <br /> <br />-,---Swint. Pool <br /> <br />_Other <br /> <br />'n <br />t ~:A <br /> <br />I;;>,~:: <br />;'~!" <br />..;.~;;'.~i~.. <br />':~ . i ; I. : <br /> <br />.'.\..]t:.\.'.<t:'........: <br />.'J " <br />~ ". <br />.'~ " <br />:i,.$,'; <br />'!'I-W.....: <br />.;"'... <br />~-~:~~~4" <br /> <br />,;;X. <br />ENERGY FORM$~f <br />. ,~~{; <br />*)'11' <br />:'~k. <br />..,~ <br />.:'.}}!-:-' <br />f ~:': -. : <br />'.~':: : <br /> <br />DESCRIPTION OF WORt: <br /> <br />-Restaurant & Health Department Approval <br /> <br />,e.~~--{! <br /> <br />BUILDING SIZE: <br /> <br />X--.,~(,{jf) <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 <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />_BUILDING <br /> <br />PERMTTS REOUESTEI! <br /> <br />.$ <br /> <br />~ ~glJ, 00 <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br />--..HECllAHICAL <br /> <br />GAS <br /> <br />ROOFING <br /> <br />~;.~:~ <br />.J:.t <br />~W .R. E. C';~ll- <br />j~l; <br />Insta11ation;'~.;I~~ i <br /> <br />: ~ ..~. <br />SPECLU.TY~J <br />Other <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />$ <br /> <br />Valuation of Mechanical <br /> <br />_PLUMBING <br /> <br />TYPE OF CONSTRUCTION: <br /> <br />_Block <br /> <br />_Fr~e <br /> <br />_Steel <br /> <br />FINISHED FLooR ELEVATIONS: <br /> <br />.......*...******************************* <br /> <br />- <br />YES NO <br /> <br /> <br />:,;';iJ,.~ <br />,.".~;.' , <br /> <br />FT. <br /> <br />IS PROJECT IN FLOoD ZONE AREA? <br /> <br />BUlLDF4R <br /> <br />~ONTRACTOR SECTIO~ <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration # <br />*****************.*~********************** <br /> <br />ELECTRTCL\N <br /> <br />Silmature <br /> <br />COMPANY <br />State Cert. or Regist.# <br />City License Registration # <br />**.**.********************...*..*.****.*** <br /> <br />?:~~': '.l, <br />;~~::.' <br />,'" <br />.~J;f~t.:.,:: '. <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. , <br />. City License Registration # <br />.************.*..*******.****.************ <br /> <br /> <br />ELUMB~ <br /> <br />MECHA~ICAL <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration, <br />.*************~*************.************* <br /> <br />lll'IIIliI ~. COMPANY -e/ <br />. I.. /..- State Cer . or Regist. , <br />Signature ~ ~ City License Registration <br />- ~ ......................................... <br />I <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />