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<br />UPLICAn~ I'ClIl HIIlIIttT <br />cJ:n 01' hl'llDlllXLLS <br />.uI'J.I)DIIf ~ <br /> <br />DUS IIIICUVI:D <br />n.urs 1lIIYI_ I'D <br /> <br />OffNER' S NAME <br /> <br />,J"oi%ES c., ~VI'5 <br />~D COL1L '* Wlorll- r:k.tt.A) l rx-rzl.:.-PHon <br />/7&500 (;TH- ? r r ?:.6P'h/l4tl.-'S l <br />BLock <br /> <br />JOB ADDRESS <br /> <br />YPr 7\2---" ({tEet <br />PC... <br /> <br />LEGAL lJESCRIl''l'ION: LOT(5) <br /> <br />SUBDIVISION <br /> <br />PARCEL ID .. <br />WORK PROP5El): OHEw CONSTRUCTION <br />~IGN <br /> <br />(OR'l'lt.rv I'RnW' PROP~ TJJC NOTT~\ <br /> <br />o ADDITION <br />o MOW <br /> <br />OALTERATION <br />o Dr.KOLrSH <br /> <br />o REPAiR <br /> <br />o INSTALL <br /> <br />PROPosED OSE: OSGL FAMILY DlfELLING <br />o COMMERCIAL <br /> <br />OMULTI-nuar.y <br />o INDUSTRIAL <br /> <br />0, OP UNITS <br />o SWIMMING rooL <br /> <br />o MOBILE HOME <br />o OTHER <br />I <br /> <br />DESCRIPTION OF WORK <br /> <br />o RESTADMNT , HEALTH DEpARTMENT APPROVAL <br />~, t./) Co/IJcll.;;,n /mAs / ~1Uc-c-O 1./). Slt;~~ <br />f I <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE HEIGHT <br /> <br />RESIDENTIAL: <br />C<>>IHERCIAL: <br /> <br />ATTACH (2) PLOT PLANS , (2) SETS OF BUUDING l'LAHS & (1) SE'!' ENERGY FORMS. <br />A'rl'ACH (3) !Ins OF BUILDING PLAHS , (1) SET ENERGY FORMs. <br />PROPERTY SURV!:Y REQUIRED E'OR ALL NEW CONSTRUCTION. <br /> <br />PEJM[TS REQUESTED <br /> <br />o BUILDINCI <br />o ELECTRICAL <br />o pLOMllING <br />o MECH1\NICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AHl' SERVICE <br /> <br />o FLORIDA POWl!:k <br /> <br />o W.R.E.c. <br /> <br />$ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF ImClfANCIAL INSTALLATION <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION:~BLOCk <br />FINISHED FLOOR ELEVATl:oNS <br /> <br />o nwa <br /> <br />o STUL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD Yl:s [J NO <br /> <br /> <br />COMl'ANY: - <br />STATI CDT OR REGI ST <br />CITY PROCESSING . <br /> <br />******..............**........***.......**.***.* <br /> <br />&1&C'l'RXCIQ' <br /> <br />SIGNATURE <br /> <br />COMPAIJY. <br />STATE CERT OR REGIST # <br />CITY, PROCESSING .. <br /> <br />**.********.......................*...*****..*.****.************.* <br /> <br />~ <br /> <br />COMPAlfY. <br />STATE CERT OR REGIST .. <br />CITY PROCESSING * <br /> <br />SIGHATUJU: <br /> <br />SIGNATURE <br /> <br />*......**~*~..***.****...***************.**..**************..*..** <br />COMPJ\!lY- <br />STATE CERT OR REGIST * <br />CITY PROCESSIHa # <br /> <br />~cu. <br /> <br />*********.****...............***.***...*************.************ <br /> <br />0'Dal <br /> <br />SIGNATURE <br /> <br />CC>><<l'ANY <br />S~TE CERT OR REGIST . <br />CITY PROCESSIHG II <br /> <br />******............*.....*......**.***.****.****...*************** <br /> <br />I'd <br /> <br />Z6Zl"ON <br /> <br />SlllHHAHd3Z jO AllJ <br /> <br />~Vg8:01 ZOOZ '8 "uer <br />