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<br />APPLICATION !'OR PEmaT <br />CITY 01' ZJ:PBYEUlILLS <br />BUILDING DB:PAan.fZNT <br /> <br />DAD RECB~OQ <br /> <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME (Pf!A/V'f) ;-/'(J(U 7 oN (fl./-I. f . <br />JOB ADDRESS -:3 7~ t/7 Lfl~.A.L-~ a-c-. <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL ID # .1'-1,2-5 -").. I - 0010- Ol? 00 - 0 '7 '3 0 <br /> <br />WORK PROPSED: ~ CONSTRUCTION o ADDITION <br /> <br />(ORT~TN FROM PROPERTY TAX NOTTCEl <br /> <br />OSIGN <br /> <br />o MOVE <br /> <br />OALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBI LE HOME <br />[!}<:; A/.....v~ I "'-" V M <br />OTHER <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />BUILDING SIZE <br /> <br />/2 )( bl.o <br /> <br />SQUARE FOOTAGE <br /> <br />c ,If /lJ16~'- <br />b'7~ <br /> <br />HEIGHT <br /> <br />DESCRI PTION OF WORK RA((,/~l? sc../lcr;!J [ltJOtvl, VT/ '-'I TI( /2. oo;Yl <br />r ' <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION, <br /> <br />PERMITS REQUESTED <br /> <br />~LDING <br />urELECTRICAL <br />o PLUMBING <br />o MECHANI CAL <br /> <br />$ II ft-L/, Lff <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />OW. R. E . C . wI tz.C s t-JtEtl <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />o NO <br /> <br /> <br />SIGNATURE <br /> <br />COMPANY El H COfJSr}l.v(../l OIV' Or-- CI"~lVrfl-/1'- f:-L-.. <br />&. jJ STATE CERT OR REGIST # ~c..O ~ r z... <br />I 00t.t..tR. CITY PROCESSING # 2" ""7 AJ~1f; ~e~T eJ?i)N"t;:: <br />5-fc..+t (rL.rt, J '.0 ~ ~rt='& ~ <br />************************************************* ****~***~**~~* <br /> <br />BUILDJ:.R <br /> <br />SIGNATURE <br /> <br />~ 1-1. <br /> <br />atuI2 <br /> <br />COMPANY IkE ~U3 c. TIlt c.. <br />STATE CERT OR REGIST # <br />CITY PROCESSING # /17 (j)1t... ~. <br /> <br />ELECTRICIAN <br /> <br />****************************************************************** <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />**********~******************************************************* <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />lirfECHANICAL <br /> <br />.*........*..........*.*******~****************.**************~*. <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />OTHER <br /> <br />************.***.***************************************.****.*** <br />