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<br />APPLICATION FOil PEmlIT <br />CITY 01' ZBPHYRRILLS <br />. BUILDIlfCJ DBPAIlTMKNT <br /> <br />DAD IUl:C2IVBD' I/)- /;;J. ;.. 0 D <br />PURl IlBVtn ......- <br /> <br />, .-A"" <br />OWNER S NAME ,Ufo-A <br />JOB ADDRESS & I ~ S' <br /> <br />C~w--I Iv> <br />A.bbrtl ~~V\ <br /> <br />PHONE <br /> <br />7?JiJ -to 7}<)7 <br /> <br />1%-. <br /> <br />'?er?jll.( I ( <br /> <br />SUBDIVISION <br /> <br />LEGAL DtSCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID , <br /> <br />3 .... J-tt - :; 1- 6 'Joo - 00 Doo - /JDty) .. 'OBTAIN FROM PROPERTY TAx NOTICEl <br /> <br />WORK PROPSED: ptNEW CONSTRUCTION <br />DSIGN <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o ADDITION <br /> <br />DALTERATIOf-t <br />o DEMOLI SH <br /> <br />o REPAIR <br /> <br />tJ iNSTALL <br /> <br />o MOVE <br /> <br />DMULTI - FAMI L Y <br />o INDUSTRIAL <br /> <br />0, OF UNITS <br />o SWIMMING POOL <br /> <br />d MOBILE HOME <br />o OTHER <br /> <br />. 0 RES~RANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WOR'-_"oa,-y (IaM./ <br />BUILDING SIZE SQUARE FOOTAGE Lf.{) ~() <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />[3'" BUI LDING <br />tf ELECTRICAL <br />g"PLUMBING <br />~CHANICAL <br /> <br />$ <br /> <br />;;. O?J, OO-V <br />, <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />, <br /> <br />FLORIDA POWER <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS 0 ROOFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION:j(BLOCK <br />FINISHED FLOOR ELEVATIONS <br /> <br />o OTHER <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />,PINO <br /> <br /> <br />SIGNATURE <br /> <br /> <br />.******************************************* <br /> <br />BUILDD <br /> <br />SIGNATURE <br /> <br /> <br />.L&CDUcIAB <br /> <br />PLUMBBIl <br /> <br />SIGNAT <br /> <br />8CBAlUCAL <br /> <br />SIGNATURE <br /> <br />0'1'IIBIl <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />