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<br />APPLICATION FOR PERMIT <br />CITY OF ZBPBYRRILLS <br />BUILDING DEPAR'l'MBNT <br /> <br />~T!V <br />/O/i 1120GB fg <br />D~ IVED. , ) <br />PLANS REVIEW I'BB - '" <br /> <br />JOB ADDRESS <br /> <br /> <br />PHONE _(fIJ) 7 r 2 .- t{ J Y 7 <br /> <br />OWNER'S <br /> <br />SUBDIVISION <br /> <br /><)J'/ve/ O#'..f's <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE \ <br /> <br />WORK PROPSED: <br /> <br />o ADDITION <br /> <br />o ALTERATI ON <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />~MMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />BUILDING SIZE <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />:LV- (;"'t)~1 rkMCy~ fr. <::. WI"""J /Nt;/ f/// alA'" of surc~ ~ <br />I I <br />SQUARE FOOTAGE HEIGHT <br /> <br />DESCRIPTION OF WORK <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 />crfu;ILDING <br />P--€LECTRICAL <br />tyPLUMBING <br /> <br />PERMITS REQUESTED <br /> <br />$ A.A,II)()- <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />FLORIDA POWER <br /> <br />o <br /> <br />I ~ -Ii> <br />w.R.E.C. .>>J IDq:1O <br />a ~.>>'iL <br /> <br />"g~1'1 <br /> <br />o MECHANICAL <br /> <br />$ j)J. <br />o ROOFING ,EfsrtdI~TY <br />( <br />OF CONSTRUCTION: 0 BLOCK <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o OTHER <br /> <br />TYPE <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />)- / .-- <br />/' ~/ r-- <br />)(J OTHER . .. c. <br />1 r' <br /> <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD <br /> <br />SIGNATURE <br /> <br />COMPANY .::rr/J:> f/QO! ~/'f7no""" <br />STATE CERT OR REGIST # G eo 5'697 K <br />CITY PROCESSING # .,:)3 5"q <br /> <br />BUILDER <br /> <br />****************************************************************** <br /> <br />~ <br />BLECTRXC1AN __~- <br />- STATE CERT OR REGI ST # e:..c..ct:xJ ~ \ ~A <br /> <br />SIGNA~..................................::::.::::::::::.:...:.~.::...... <br /> <br />COMPANyK-dWU(\,,,,-> t\e.c... SVL en <br /> <br />PLUMBER. <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />**********~******************************************************* <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />MECHANICAL <br /> <br />OTHER <br />( <br />SIGNATUR:g- <br /> <br />'. :;:;1;;...:j)=...............:~:::....~ZC)..~~ <br /> <br />STATE CERT 'OR REGIST # /?~.lJ Y.'4-/ <br />r~:- CITY PROCESSING # /6~Y- <br /> <br />~-:*************************************************************** <br />