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<br />04/15/2001 22:29 <br /> <br />17278199343 <br /> <br />JACKS AIR CONDITION <br /> <br />U1JLJ:CA'UOIt I'Oa I'IDIIMI!' <br />CITY O~ IaPlYRRtLLS <br />BUIID11fG DKPAll!Mml'1' <br /> <br />PAGE 03 <br /> <br />DAB UCKrv&D <br />PLAVa DVID I'D <br /> <br />OWNER'S NAME '5 rf\ \11--\ l &\t{\"t;;O ~ ~~ )0. <br />JOB ADDRESS b<oLfS .:s: ~A\P"" C* <br /> <br />PHONE (~'~\\lq- O~:L <br /> <br />I <br />, <br />SUBDGrSION D~~ 5.Jb- <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTl I~ ~OTICE) <br /> <br />WORK PROPSEo: DNEW CONSTRUCTION <br />DSIGN <br />PROPOSED USE:~ FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o ADDITION <br /> <br />OALTERATION <br />o DEMOL! SH <br /> <br />o REPAIR <br /> <br />IiJINSTALL <br />et.pa..-c~ <br /> <br />D MOVE <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />Oft OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />CJ RESTAURANT " HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRI PTION OF WORK J<.t If'\N ~t... ~ ~ f \r...( r <br /> <br />~ ~ ~~ ~,',(" <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 />PE~TS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRI CAt <br />o PJPMBING <br />Ql"'"MECHANI CAL <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />FLORIDA POWER <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />./ <br />iJO. <br /> <br />$ <br /> <br />\ SOD - <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 BLOCK <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 D NO <br /> <br /> <br />BUILOD <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />........***..**...............*.................**..*.************ <br /> <br />.LaC'.l"RICIM <br /> <br />COMPANY <br />STATE CERT OR REGIST * <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************... <br /> <br />PWMBD <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />...........~.....................................t..~......~ <br />COMPANY ~,..k~" -~ ~. '.~<. <br />~ ~ STATE CERT OR REGIST ft . CO <br />, CITY PROCESSING # \ ~~ <br /> <br />MaC'JIAJIIClU. <br /> <br />*********************************************************..****** <br /> <br />O'I'IID. <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />******************.**.**..*..*................................... <br />