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<br />APPLICATION FOR PERMIT <br />CITY OJ' UPHYlUIILLS <br />BUILDING Dll:PAR'l'MIi:HT <br /> <br />/~-13-())6 <br />DAm RECEIVED <br />PLANS REVIEW I'll:ll: <br /> <br />OWNER'S NAME tJA/V!J/f /( JV,;L-L <br /> <br />JOB ADDRESS 3tff/Lfh 3 f.IJ. fJ\lC . <br /> <br />PHONE g-13 - '71'2 - /00 tf <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # II~ U- ZI- nO! 0 - {q q(9D- (90 II <br /> <br />WORK PROPSED: ~W CONSTRUCTION <br />Os I GN <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />IOBTATN FROM PROPERTY TAX NOTICE) <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />OMULTI - FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />~ER <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK 0Xr fLp,(~pf} SL-HIJ ('t9NC/l-t::-r-c 6N/.-cr <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (I) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (I) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ I Lf5f.o. 2-.0 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />D SPECIALTY <br /> <br />D OTHER <br /> <br />TYPE OF CONSTRUCTION: D BLOCK <br /> <br />o FRAME <br /> <br />D STEEL <br /> <br />D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D NO <br /> <br /> <br />SIGNATURE <br /> <br />R~ fl. ~ <br /> <br />COMPANY 81' f.-( (()/'Ihr/lu.-t/Dn..! or-:- C6'~ t=l f <br />STATE CERT OR REGI ST # cat 0 5" 1'}'7 t""Z- <br />CITY PROCESSING # 2(P <br /> <br />BUILDER <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />**********~******************************************************* <br /> <br />MECHANICAL <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />**************************************************************~** <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />