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<br />APPLICATION FOR PBRYIT <br />CITY OF ZBPHYRRILLS <br />BUIlDING DEPARTMENT <br /> <br />DATE RECEZVBD <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME '/-E./, /10 5 "mfAr r <br />JOB ADDRESS d?.J~O ~7lh ~ ~~l,r~,/I~) <br />LEGAL DESCRIPTION: LOT (S) ~ BLOCK fo <br />PARCEL ID # tl2P:J~n ~~ ,;(h..;7') <br />WORK PROPSED: ONEW CONSTRUCTION <br />o SIGN <br /> <br />PHONE <br /> <br />7.51 -1- t? f./ B~ <br /> <br />~r;~ ~~~ <br /> <br />::::::s:::~:~: ~t~F.1 <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o ADDITION OALTERATION o REPAIR o INSTALL <br />o MOVE 0 DEMOLISH <br />OMULTI-FAMILY 0# OF UNITS o MOBILE HOME <br />o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />~:41/ jJ&~/ p~)1 <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 & (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 />o BUILDING <br /> <br />$ <br /> <br />5~7"o.6e <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br />o PLUMBING <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />o MECHANICAL <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 AREAD YES <br /> <br />o NO <br /> <br /> <br />BUIlDER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />BLBCTlUCIAN <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 />MECHANICAL <br /> <br />**********~******************************************************* <br /> <br />COMPANY: <br />STATE CERT OR REGIST # <br />CITY PROC~SSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />SIGNATURE <br /> <br /> <br />COMPANY d~dl ~r4-1JrF ~? <br />STATE CERT OR REGIST # (" C"CtP<7I~67~ <br />CITY PROCESSING # , <br /> <br />OTHER <br /> <br />************ <br /> <br />******************************************* <br />