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<br />~tt~d <br />APPLICATION FOR PERMIT ~ " <br />en" OF ZBPHY1IBILLS "ift.- '7(01 '-/ III 10 I <br />BUILDING DEPARTMENT D RECEIVED <br />-- S REVIEW FEE <br /> <br />OWNER'S NAME .,J)~ Ctnt:tUl~ PHONE 78l{ - 3 7 y~ <br />JOB ADDRESS Iff? AO I '-mkr lul::< '1 <br />LEGAL DESCRIPTION: LOT(S) IV BLOCK / SUBDIVISION ~ ~ <br />PARCEL ID # IS ':' ~- 21- 0 Z 00- OODOO.- 0140 (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPSED: ;>r(NE~ CONSTRUCTION 0 ADDITION DALTERATION 0 REPAIR 0 INSTALL <br />o SIGN 0 MOVE 0 DEMOLISH <br />PROPOSED USE:)1SGL FAMILY DWELLING DMULTI-FAMILY 0# OF UNITS 0 MOBILE HOME <br /> <br />o COMMERCIAL <br /> <br />o INDUSTRIAL <br /> <br />o SWIMMING POOL <br /> <br />o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK ~ vj;z,~ ~~ <br /> <br />BUILDING SIZE <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />~ BUILDING <br />~ ELECTRICAL <br />)Q PLUMBING <br />~ MECHANICAL <br /> <br />o GAS <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />ATTACH (2) PLOT PLANS & (2l SETS OF BUILDING PLANS & (ll SET ENERGY FORMS. <br />ATTACH (3l SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />$ <br /> <br />c.s; 000 <br /> <br />~D <br /> <br />o W.R.E.C. <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />~ FLORIDA POWER <br /> <br />AMP SERVICE <br /> <br />$ <br /> <br />~, 4>60 <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o ROOFING <br /> <br />o OTHER <br /> <br />o SPECIALTY <br /> <br />TYPE OF CONSTRUCTION~ BLOCK <br />FINISHED FLOOR ELEVATIONS <br /> <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />OTHER <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES )(NO <br /> <br />COMPANY <br />1\ - If. .;? J7 If STATE CERT OR REGIS~ ~ 0.-- - CD <br />~ . ~ CITY PROCESSING # 2 ~0 <br />Need c..v( <br />****************************************************l************* <br /> <br />COMPANY ~ -fJ~ <br />STATE CERT OR RE ST # 6 R - C~O() 9 sct3 <br />CITY PROCESSING # ;;;.0 (p ( <br />0(( <br />****************************************************************** <br /> <br />~Ij.~ <br /> <br />COMPANY J~ ~:uv <br />f'\ . it LJ t1 I STATE CERT OR REGI ST # C ~ - L 0 '5' 7'7 0 '-1--./ <br />~~J '. I\..e~/ CITY PROCESSING # ; I g '& 0 / <br />oK- ( <br />* * * * * * * * * * *.* * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * *Z;:;::L..;*;": *~*v * * * * * * * ~ <br />COMPANY -~ <br />n -- ~ ;;J /J J STATE CERT OR REGIST # e Q> J S-Oc:JeJ. <br />rAJiA~ -----' ~,;:.- CITY PROCESSING # S '3 <br />/,>/( <br />************************************************************~**** <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />***************************************************************** <br />