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<br />OWNER' S NAKE PHONE <br /> <br /> <br /><6 <br />~/q <br />;~ <br />:) <br /> <br />(p L( <br />,ff'd--/O <br /> <br />OWNER · S ADDRESS <br />JOB ADDRESS '7 ~ I .5 /2..0 ~ IK- '1 fLoo rf <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D.' ~ If- ~ - '2-1 - OOt)() - 6tJ J 0 0 - '2- 5 <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _A1teration --.Repair _Install <br /> <br />_Sign <br /> <br />~ove <br /> <br />_DeJIOlish <br /> <br />PROPOSED USE: _Single Faai1y <br /> <br />_KIF <br /> <br />_' of Units _K/H <br /> <br />_eo..ercial <br /> <br />_Indust, <br /> <br />_Swia, Pool _Other <br /> <br />-:-.-Restaurant 5: Hea1t:h Departaent Approval <br /> <br />DESCRIPTION OF WORK: 5Cfl,t~/J P_Db-dl . 614(lJJ8ftTf <br />( <br /> <br />/J - 12 ()$-rIA <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />.- <br /> <br />L~ At <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS 5: (2) SETS OF BUILDING PLANS 5: (1) SET ENERGY FORKS, <br />ATTACH (3) SETS OF BUILDING PLANS 5: (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />_BUILDING <br /> <br />$ <br /> <br />5 ~ .so, ()D <br /> <br />PERMITS REOUESTED <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 />~CllANICAL <br /> <br />$ <br /> <br />Va1uation of Kechanical Inst:a11ation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF ooNSTRUCTION: _B1ock _Fraae _Steel <br /> <br />Other <br /> <br />FDlISHEO FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BUII.DER COMPANY Sf H ('ON> rlLJc. T I CJ,J OF C~lfft.ll<. U. <br />9-1~. A ~ State Cert. or Regist. , /'~ !;7'(ztf'''z.... <br />Signature ~ ^ 1l P aJ!..L1L City License Registration . ,.;t <br />****************************************** <br /> <br />F.I.~CTRICIAR COMPANY <br />State Cert, or Regist, . <br />Sionature City License Registration . <br />****************************************** <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist, t <br />Signature City License Registration . <br />****************************************** <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. I <br />Signature City License Registration . <br />****************************************** <br /> <br />OTIIRR COMPANY <br />State Cert. or Regist, t <br />Signature City License Registration . <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />