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<br />U>>UCHICIIIJ I'OR RJIKl'l" <br />eI!'! 01' ZBPIlDlBILLS <br />BtJJ:LDDl'G ~U'JMPn.' <br /> <br />.DIoB UCKrYBD- <br />PUIlI8 BBVIn I'D <br /> <br />OWNER'S NAME <br /> <br />(; 1:: <br />~/JrIC: <br />JOB ADDRES.~. ~\ /t y ~ n ).L ~ /I.) <br />LEGAL DES~I6Ni~ LOT(S) Bl.OCK <br />/ ~ - .,:) ~ -;)./-tj/iJt) -tJ/1~t1-d/4()ORTATN <br /> <br />PHONE ~'1iJ- 772- d-~ 70 <br />Zc:-phyrhl//c5 I-L 3~s-L/b <br /> <br />SUBDIVISION <br /> <br />l'ARCSr.. ID # <br /> <br />fROM PROPF.RTY TAX NOTTev-I <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br />OSIGN <br /> <br />o ADDITION <br />o MOVE <br /> <br />OALTERATIOK <br /> <br />o REPAIR <br /> <br />liYtNSTALL <br /> <br />o DEMOLISH <br /> <br />, PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />Dw.rLTI - FJlMIL Y <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />~OTHERL ~ <br />t,!JmrYltll1lC-I1-- T ,16-'/) S' <br /> <br />BUILDING SIZE <br /> <br />/n<3-lcu! <br />;V:/ It- <br /> <br />D Rl'>STAUnANT " HEM.TH DEl'ARTMENT APPRO~ <br />Cz1) flj'J h~.s 7 C2. c:J t:L~,. ~/ e c~l-r / ~ " <br /> <br />f-tp let.; <br /> <br />DESCRIPTION OF WORK <br /> <br />SQUARE j;'QOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS Ii (2l SETS OF BUILDING PLANS Ii (l) SET ENERGY FOllMs. <br />COMMERCIAL: Jl.TT.1\.CH (~) SETS OF BUILDING PLANS Ii (1) SlE'I' BNERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />o BUILDING <br /> <br />PERMITS REQUESTED <br />$c23 ODD. OD VALUATION OF TOTAL CONSTr:tUCTION <br />.::(J 00 AMI' SERVICE ~LORIDA POWER 0 <br /> <br />W.R.1l:.(~. <br /> <br />o ELBC'l'IUCAL <br />o P1.UMBING N I it <br />o MECHANIcAl, IV/A <br />o GAS 0 ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLM'ION <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION' 0 BLOCK <br /> <br />o FRAME <br /> <br />EI STEEL <br /> <br />~TH)!:R <br /> <br />FIHISBBD FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD'YES 0 NO <br /> <br />EJ~~-~~~~Jil~~~~~~~~~~~~;';~ ~~~~i~:r~~~~~ ~~. <br /> <br />SIGNATURE <br /> <br />~ """"""" M tLsfec /)rfh ./fYY>--'I l~ <br />'l?~ ~~~~Ep~~~~S~~ ~GlST ~:-;;;~4>r4~~ <br /> <br /> <br />..*..************************..".~***..***...... . - ~ <br /> <br />COMl?:Nrr SU ulh '-LlvT- E/~ ~ln ~ of [t/)Y}J me' <br />STATE CERT OR REGIST # cellD I ,Q I <br />CITY PROCESSING lI' ()U 'a 0 <br /> <br />.......***....*....****+..*~**~****~**** * * ***~ <br /> <br />BUIU>D <br /> <br /> <br />SIGNATURE <br /> <br />Ji'LtIIIBBR <br /> <br />SIGNATURE <br /> <br />IVJJq- <br />. <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />-fir. .............. *,.'" ........" 'It "'.... ***** '" '* '" "',. ~ ****** * ** "'If".'" * tit *.. '* * ** w* ~ oN. 'lit" '* "W-Po <br /> <br />!lllCllMlJ:CA.L <br /> <br />SIGNATURE <br /> <br />(VI It <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />****~**~***~**.**.~*.***.**~****.******************************** <br /> <br />OTIID <br /> <br />NII4 <br />, ( <br /> <br />Cmn'ANY <br />STAT!!: CERT OR RE:GIST if <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />*************w***..********************************************** <br /> <br />'d t8100N <br /> <br />SllIH~AHdjZ jQ AllJ <br /> <br />~VOl: 6 100,; .tZ' uer <br />