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<br />APPLICATION FOR PERMIT <br />CITY 01' ZZPRYRRILLS <br />. BUILDING DEPARTMENT <br /> <br />DATi: 1Ul:Cl:IVKD <br />PLANS uvtn dIt <br /> <br />JOB ADDRESS <br /> <br />Lor /0 <br /> <br />Gofd f/;1edC{j /Ir;n li~\ PHONE 7fJ8--6Jr7 <br />S :L\....\:x:> f 0cL1< s \f. i l ~W:. Phi). <:/;1 0AJ0 <br />, /'0 '~II/J~7Yl< <br />I 0 BLOCK ~'-(( SUBDIVISION ~ <br />03-Z&-2../ -():}oo-mf"yx) --"OBTAltJ FROM PROPERTY TAx NOTICE} <br />~ loC <br />o ALT ERAT I OtJ <br /> <br />OWNER'S NAME <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />~ARCEL ID # <br /> <br />WORK PROPSED: ~NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o REPAIR <br /> <br />tl INSTALL <br /> <br />OSIGN <br />PROPOSED USE: Q!SGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLI SH <br /> <br />OMULTI - FAMI L Y <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />d MOBILE HOME <br />o OTHER <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK ^Jew fJo~ <br />BUILDING SIZE ~ <br /> <br />ffiu\Jdr1trnAJ <br /> <br />SQUARE FOOTAGE <br /> <br />Z Dc)8 <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 />o ELECTRICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />o PLUMBING <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 BLOCK <br /> <br />181 FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES ~ NO <br /> <br /> <br />BUILDD <br /> <br />SIGNATURE <br /> <br /> <br />COMPANY <br />STATE CERT OR REGIST <br />CITY PROCESSING # <br /> <br />***************************************************************** <br /> <br />.LBCTlUCIAR <br /> <br />COMPANY. <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />PLUHBIUl <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />**********~******************************************************* <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />ImCJIARICAL <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />.-c..- <br />