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<br />A>>PLlCATION rOR PERNI~ <br />CITY or IBPHYRKILLS <br />BUI LOl.lll(J UKPAR'l18HT <br /> <br />DATIl u.c:av'aD ~.-- <; - () C) <br />PLaN. uvmw ra <br /> <br />OItNER'S NAME KO\DV\d <br />JOB ADDREss3'8> 7 .5~ <br /> <br />L~J <br />U LJ \ (',0. 1\ t.r <br /> <br />, PHOlfE,.j'3<6.- 5484- <br />2QP~'fr~:lk,./,c-l (lJ~llo.3e ~rouJ <br /> <br />SUBDIVISION <br /> <br />LEGAl. DI!::.lCRIPTIOtl: LOT'S) <br /> <br />BLOCK <br /> <br />PARCEL ID II <br />wonK PROI?SED: ClNEW CONS'l'RUC'I'LON <br />DS1GN <br /> <br />'OBTAIN ~~OM PROPRATV ~AX NnTl~R\ <br /> <br />o ADf'L'l'lON <br /> <br />OAI.1'EAA'l'lON <br /> <br />o REPAIR ~NSTAJ.L <br /> <br />o MOVE <br /> <br />o DEMOI.ISH <br /> <br />PROPOSED USE,OUGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DM1JL'I'I-FAMILY <br />o INDUSTRIAL <br /> <br />Oft OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOMJ: <br />)(OTHER <br /> <br />o RESTAURAtIT , HI!'.ALTH DEPARTMENT Ai?PROVAL <br />DESCRIPTION OF WORK S:" ~ J '\ Y"'\.s. \n \ \ <br />\ D X ILl <br /> <br />BUILDING SIZE <br /> <br />)YO <br /> <br />\? '/ \, <br />HEIGHT C> to <br /> <br />SQUARE FOOTAGE <br /> <br />RES I IiE:In'IAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT PLANS, (2f SE'I'S OF BUILDING PLANS, III SET ENERGY FORMS, <br />ATTACH (3) SETS OF BUILDING PLANS, 11) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTIOtl. <br /> <br />+UILDIlIG <br />o ELEC'l'RICII.L <br />Cl PLUMBING <br />o MECHANICAJ. <br /> <br />PERMI'l'S REQUESTED <br />$ 15 ro .00 VALUATION OF TOTAL CONSTRUCTION <br /> <br />,. ....,....--.", <br /> <br />o FLORIDA POWER <br /> <br />o <br /> <br />AMI? ZERVICl:: <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF M8CliANCIAL INSTAL!.A'l'ION <br /> <br />o GAS <br /> <br />o ROOIrlNG <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONS'fRUCTION, 0 BLOCK <br /> <br />o FRAME <br /> <br />o S'l'EEL <br /> <br />o O'rHER <br /> <br />I'INISIlED FLOOR ELEVATIONS <br /> <br />I S PROJECT IN FLOOD ZONE ARI!:AO YES 0 NO <br /> <br /> <br />~':,.~~ ~E~~i.~~.~,,:'" I <br />.:z::i~',~""'~~~;1~~':"" <br />( , <br /> <br />...*.....*.*....*.*~....*..t...**....*.~...**.....AA.*............ <br /> <br />~ <br /> <br />COMPANY <br />STATE CERT OR REGIST . <br />CITY PROCESSING . <br /> <br />SIGNATURE <br /> <br />**........*,*..*...**i*...**..*...*~.**....*........*.~.***........ <br /> <br />BCIlANICAL <br /> <br />COMPANY <br />STATE CERT OR REGI ST . <br />CITY PROCESSING I <br /> <br />SIGNATURE <br /> <br />+*~~.~~.*~*~~~......*.~~.~.~..~,~*...**~.~.*....***........*+.... <br /> <br />0'1'10:1\ <br /> <br />COMPANY <br />ST~T~ CERT OR REGIST * <br />SlGIIATU!l.E __________ cay PROCESSING II <br /> <br />..*.*k..*......~..*.'~~**.*...~........*..........*****~..***..*.* <br /> <br />")0 <br />~ <br />3D <br /> <br />cU <br />~6__ <br />4 <br /> <br />'!'jI <br />