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<br />APPLXCATXON rOR PBmfiT <br />CXTY 01' ZBPBYRBXLLS <br />BUXLDU1G DBPAR'DIBNT <br /> <br />DAD RBCB:tVBD <br />PLAlIS RBVIBW I'BJI <br /> <br />OWNER'S NAME ]);( '{I it L ;j)u f ~ C ~ <br />JOB ADDRESS ~/t(8 It; VI Sr~i::l 2tEPI/~;ftll/.../..~ <br />LEGAL DESCRIPTION: LOT (S) If) 3 BLOCK <br />PARCEL 10 # 0:2 -,j C. .' ~ / - 0 I r rJ- {", tJ [l tJ 0 - () .2 :; 0 <br /> <br />PHONE 71 (' /' I () i b <br />fl. 315''/0.- 2..') 08' <br />SUBDIVISION Zt;;flfr,f \3f'~?~(5 <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE} <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br />o SIGN <br /> <br />o ADDITION <br /> <br />o ALTERATI ON <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o Dlj:MOLISH <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 MOBILE HOME <br />lil OTHER5IfO <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />BUILDING SIZE <br /> <br />IDX./:l <br /> <br />SQUARE FOOTAGE <br /> <br /> <br />IJ-o <br /> <br />DESCRIPTION OF WORK <br /> <br /> <br />11,,-; j) -' W tJo I <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 />o BUILDING <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />~/ "--~ PERMITS REQUESTED <br />C$ ~) vALuATION OF TOTAL CONSTRUCTION <br />AMP SERVICE 0 FLORIDA POWER 0 W.R.E.C. <br /> <br />~ <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 B~OCK <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 0 NO <br /> <br />il!!!!!!!l!!!!l!l!ll!III!!lllll!l!!!ll!I!II!ll!III!I!!i!llll!!lli!l!l!l~I!III!llli!III!llml!!lill!IIII!: -- - - - -- - - ;!ljilll~IIIIII~I!!III!I!!lii!illli!IIIII!!illi!!IIII!Ilmmlilll!lil!!!!II!jllllll!ll!II!II~!!I!l <br /> <br />SIGNATUR <br /> <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />BUXLDJDl <br /> <br />***************************************** <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />BLBCTlU:CXD <br /> <br />I <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />PLUMBBR <br /> <br />* * * * * * *****.* * * ** ** ** * ** ** * * * ** * ** * * *** ** * * * * * * * * ** * .-** * * * * * * * ** * * * <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />ImCJIARXCAL <br /> <br />***************************************************************** <br /> <br />OTBBR <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />