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<br />OIIIlEJI'S llAlU\ ,{/ ~j? .
<br />oWlfEtt'8 AOOUSS 3~/c;?
<br />Job AtJDttMS ;:J 7 '?/-2
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<br />AttI'LU::A'tlUN "Oft I'ItRHlT , -( ~
<br />CITY tJ~ !8ft"YlUftLLS' 'P. tl..
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<br />PJlONE
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<br />LEGAL DESCRIPTIONt LOt(S) BLOCK SUBDIVISION ZLI'/'l'1t - e f), 0
<br />
<br />PARCEt. 1.b.' 0 j :-;Jc{.;) / 0/.]0 --C/cJouu -02--yd (oBtAIN FROK PROPERTY TAX NOTICE)
<br />~/
<br />woRk PROl'OS8Dt____NeV tondttuctlob ----AddItion ----Alteration ~epalr ____Install
<br />
<br />_Sip
<br />
<br />--1tove
<br />
<br />--Pe.o1i9h
<br />
<br />.
<br />PROPOSEb USE! _Silille r...Uy
<br />
<br />-1:I/r _' of Uults -1:1/11
<br />
<br />_t~erc"l
<br />
<br />_lndust. _Swill. 1'001 _Olher
<br />
<br />-..ReataUl"ant & JlealLh Depal"L.ent Approval
<br />DESCRIPtION OP WOUI Ct:11? ;;;/<.312- T .,j- al~{,/r2(.r
<br />
<br />BUILDING SIZ8t
<br />
<br />x
<br />
<br />..s'l{) Square reet. $'1' Jleigltt
<br />
<br />RESIIJ~NT1ALi, AtrAoo (2) PUJT PLANS , (2) S8tS Of' BUIIJJING PLANS & (1) SET ENERGY FORMS.
<br />cotlMtmtttAt I" AtrAtIIU) 'SBTSb' JutlJJINC l't.ANS , (1) S8T ENDGY FORMS.
<br />,J.Ulttut1't sua,u .UQutltllJ t:'oA'.AtL NI" OONSTRUCTtON. .
<br />\ j. '"!',.. . '1' _",',' ..
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<br />rERH1TS.~U&SI8Q
<br />
<br />" .. I
<br />,$ .~Y9~/~-- -,
<br />
<br />Valuation at Total Construction
<br />J I . j
<br />
<br />V;UILDING
<br />------Hl.ECTRlCAL
<br />---"ECUAJelCAl.
<br />----'LtMblMd
<br />
<br />1 H
<br />
<br />AIIP Service
<br />
<br />;l' ..
<br />
<br />(florida Power Col"p.
<br />
<br />W.R.E.C.
<br />
<br />,$
<br />
<br />valuatlolt of HecbAuical tnstallation
<br />
<br />GAs
<br />
<br />. RUOF1NG
<br />
<br />SPECIALTY
<br />
<br />TYPE OP CONStRUCTION' \ --...Block _Frue _Steel
<br />
<br />Other
<br />
<br />FIfUSIIKD ttooR BLBVAtl0NS:,..,. .n.,
<br />
<br />IS "RtJJE~'1' IN FLOOD ZONE ARXA 7
<br />
<br />, .,:; " ...
<br />
<br />YES
<br />
<br />NO
<br />
<br />.,.........."".,......."....,..........
<br />r -I ~ ~ I '. !
<br />
<br />", .
<br />. .
<br />, . .-':-. ..., CONTJIAcfol. SECTION
<br />//'<'p/ ~ ,) :,.~ '. ' ",. #~C5 ';;fZ<~, .
<br />BUILDER //, / . ./ .,~!<<*tfANt.... ",
<br />~ i:'-O:/~ . . ":,/; . .. 'j .fAtae tert, ar Relllt, '-M
<br />Sigtu*tttre.F :;z.~-,-------- / CU, Lh:enae ltegl8tt"aHon .
<br />'/ ....*...........".".................~...
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<br />~e (!.; OJY t: ,If)
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<br />~ "-~
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<br />
<br />EI.E(,....R1 tJ.An
<br />
<br />CoHPAMY
<br />state Cert. or RegiRt. J
<br />titr License Registration ,
<br />..........................................
<br />
<br />SiRf.l8ture
<br />
<br />CUIf.ltANY
<br />StAt@ Vert. or Reai8t. ,
<br />City License Registration .
<br />.................,........................
<br />
<br />PLutlBER
<br />
<br />Signature
<br />
<br />CUtIPANY
<br />StAte Cert. or Relist. ,
<br />. oity License Regidtration ,
<br />...................".,...................
<br />.
<br />
<br />HE('11AH1CAL
<br />
<br />Signa ttUe
<br />
<br />COtlt'ANY
<br />state cert. or Reglst. ,
<br />tity License Registration"
<br />:..........................................
<br />
<br />O'lIlRR
<br />
<br />SigtlatUr:e
<br />
<br />ArrnC^TION APPROVED BY
<br />
<br />PERMIT OFFICr-;R.
<br />
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