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<br />APPLICATION I'OR PBRMIT <br />CITY or ZBPHYRBILLS <br />BU:ILDING DBPAR'DdBNT <br /> <br />DATI: RBCJlIVBD <br />PLANS RBVID I'JDI <br /> <br />i2-?--DU <br /> <br />~ OWNER'S NAME ~~ ~ kJ~ <br />.:x JOB ADDRESS M -~ J ~ ~ !o!i SA-, <br />LEGAL DESCRIPTION: LOT (S) . ~ o:z.1 <br /> <br />PHONE f':<~ <br /> <br />b:lV f <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />y PARCEL ID #- <br />WORK PROPSED: 40NEw CONSTRUCTION <br />OSIGN <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE} <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o D~OLISH <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />O#- OF UNITS <br />o SWIMMING POOL <br /> <br />o M:OBILE HOME <br />o OTHER <br /> <br />...)( DESCRIPTION OF WORK <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />I 2 Y I~ Shed <br /> <br />BUILDING SIZE <br /> <br />.; <br />SQUARE FOOTAGE <br /> <br />19~ <br /> <br />HEIGHT <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 />~ <br /> <br />~ILDING <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />~ 9r;~ <br />SltQ6 <br /> <br />po <br />PERMITS REQUESTED <br /> <br />d$ <br /> <br />VALUATION .OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <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 />BUILDER <br />4IGNATURE ~j~ <br /> <br /> <br />~D~ <br /> <br />COMPANY <br />STATE CERT OR REGIST <br />CITY PROCESSING #- <br /> <br />****************************************************************** <br /> <br />BLBCTlUCIAH <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST #- <br />CITY PROCESSING #- <br /> <br />I <br />****************************************************************** <br /> <br />PLUYBBR <br /> <br />COMPANY <br />STATE CERT OR REGIST #- <br />CITY PROCESSING #- <br /> <br />SIGNATURE <br /> <br />MBCllAHlCAL <br /> <br />** * * * * *** * *.** * * ** * * * * * * * * **** * * * * ** * *** * ** * * * * * * * * **'* * * * * * * * * * * * * * <br /> <br />COMPANY. <br />STATE CERT OR REGIST #- <br />CITY PROCESSING #- <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />OTBBR <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST #- <br />CITY PROCESSING #- <br /> <br />***************************************************************** <br />