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<br />APPLICATION rOR PBlUaT
<br />CXTY or BBPHYRHXLLS
<br />BUILDING DBPARDO:NT
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<br />DATIl RIlCBIVBD" ~ If Ie; (
<br />PLANS RIlVIn ....
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<br />1
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<br />OWNER'S NAME ~ (,' L J l1S
<br />JOB ADDRESS :5 ') *5
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<br />Df') I'Yl J ~ 8 tIl-/j
<br />LJEf1...15 k'5' # j J? E
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<br />PHONE " IJ. :9- B 2: 6 ?
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<br />SUBDIVISION
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<br />1'1
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<br />LEGAL DESCRIPTION I LOT(S)
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<br />BLOCK
<br />
<br />PARCEL ID It
<br />WORK PROPSEDI ONEW CONSTRUCTION
<br />
<br />~ITION
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<br />, IORTATHI!'ROM PROPRRTY,TAx NOTleR'
<br />
<br />QSIGN
<br />PROPOSED USEI~FAMILY DWELLING
<br />
<br />o MOVE
<br />
<br />DALTERATION
<br />o DEMOLISH
<br />
<br />o REPAIR' ' , d INSTALL
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<br />l' " "'~ II. I
<br />
<br />: I',
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<br />tJ COMMERCIAL
<br />
<br />OMULTI":'FAMILY
<br />o INDUSTRIAL
<br />
<br />Off OF UNITS f" ' '1' 0 MOBILEHOMB:
<br />f,
<br />
<br />o SWIMMING POOL tJ OTHER
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<br />, ,
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<br />CJ ,RESTAUAANT & HEALTH DEPARTMENT APPROVAll
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<br />'.,-J, I ,i ~ ' r;
<br />
<br />DESCRIPTION OF WORK b;( ) <f ...s c..R. CE ()J I<rro n ,
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<br />'HEIGHT'.,./t).. ..Cb.-
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<br />BUILDING SIZE 6.x. . ry SQUARE FOOTAGE 8-?
<br />RESIDENTiAiJt
<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 FOJ:U.fS. .;:.. ~".:
<br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. ,~! r ; ,
<br />
<br />11/,\
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<br />'PERMITS.REQUiSTED
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<br />1".' " pit' I.'.::
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<br />o BUILD,ING
<br />[j ELECTRICAL
<br />
<br />$
<br />
<br />'2.) 90'
<br />
<br />VALUATION OF TOTAL CONSTRUCTi6k
<br />. ,", 'j .-, 'J,I'
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<br />.AMP SERVICE 0 FLORIDA ~OWER' ,0
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<br />o PLUMBtN,:~, .
<br />D MECHANiCAL $
<br />,:q,,~~, ~t 1~,~q~Fp~G ,,tl SPECIAtTY" '
<br />TYPE OF CONSTRUCTION: 0 BtOCK
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<br />'.VALUATION OF MECHANCi:Ai. iNSTALLATION:/l\')" : I',! I
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<br />FiNISH~~;~~~R ELEVAT:t.ONS
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<br />0 OTHER
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<br />tJ FRAME 0 STEEL
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<br /> IS PROJ,ECT
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<br />tr6THER ' ,
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<br />IN FLOOD ZONE ~tJ'; Y~S' ,
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<br />" i ': SIGifATtJRE Ila~ ,-,_~ CITY PROCES~i:NG ft " ''',__Jl .: .',' ',,',11:,,' ,
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<br />memem ".
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<br />SIGNATURE
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<br />COMPMY
<br />STATE CERT OR REGIST .
<br />CITY PROCESSING It
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<br />COMPANY'
<br />STATE CERT OR REGIST.ff
<br />CITY PROCESSING # ^
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<br />l'LUIIBD
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<br />SIGNATURE
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<br />COMPANY.
<br />STATE CERT OR REGIST#.
<br />CITY PROCESSING #
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<br />YIICWICAL
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<br />SIGNATURE
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<br />COMPANY
<br />STATE CERT OR REGIST It .
<br />CITY PROCESSING It
<br />
<br />SIGNATURE .
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