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<br />CoOl e G <br /> <br />~(I- <br /> <br />-i <br />/~ .~ <br />)} tJ 0 <br />\/ ~(~ ~/ <br /> <br />OWNER'S NAME <br /> <br />0ff1 <br /> <br />5~30 <br /> <br />t2-u't-,~. 01- ~ <br /> <br />_PHONE <br />{JD) (}--' J <br /> <br />OWNER'S ADDRESS_ <br /> <br />-- <br /> <br />- <br /> <br />~5 3C ~' <br />1, . . <br />~S......~ <br />r 0 .30 <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: <br /> <br />.DIVISION <br /> <br />PARCEL 1. D.' <br />WORK PROPOSED:1i!!!. <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />Alteration -.Jtepair _Install <br /> <br />_Sign <br /> <br />~OVt: <br /> <br />.Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_M/F <br /> <br />_' of Units _K/H <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Departilent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />8)( 12. sift)) f l~x:3 / s cf<, E'EP /?7fb;>J <br /> <br />!l / . -Eft/ Il 'DQt-1 <br />Square Feet. Height sq.c "2.A <br />) rX3 / .:l.srL <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />8 <br /> <br />x/2- . <br /> <br />96 <br /> <br />BUILDING SIZE: <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />PERKITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ 45-017 <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />--.HECIIAIIlCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUKBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FIlUSBED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA! <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />BUILDER <br /> <br />CONTRACTOR SECTION <br />__r _ <br />~// COMPANY Jl\)5 CV/l/S / <br />/^:> .,. '. .. State Cert. or Regist. , Cf{ Co ~~z..., I <br />~A_______________ City License Registration t /~9 <br />****************************************** <br /> <br />Signature <br /> <br />=CIAHI1~4 COMPANY <br />LJ ", State Cert. or Regist. , <br />ure. '. .... City License Registration t <br />********* ******************************* <br /> <br />~ .9.0/'( <br /> <br />PL1JMBER COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />****************************************** <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration . <br />****************************************** <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. .. <br />Signature City License Registration I <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />