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<br />APPLI:CATI:OH FOR PBRIaT <br />CI:TY 01' ZBPIIYlUII:LLs <br />BUJ:LDI:RG DEPARTMENT <br /> <br />L(~i~~d (~-. - ~~'~~ <br /> <br />DAD RBCBI:VBD 1- \.f - 02." <br />PLANS REVI:BW I'D <br /> <br />OWNER'S NAME <br /> <br />~IE- <br /> <br />HUN I' N 6-,,,,,...) <br /> <br />E ~ K.... <br />~I>< Tr Cl;J A-l PHONE <br /> <br />JOB ADDRESS 7 '3 "--f cJ <br /> <br />&-A L L., <br /> <br />D> l-vf) <br /> <br />Z ~I H '{.. fZ- ~ c"c L5 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />,SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br />~N <br /> <br />o ADDITION <br /> <br />o ALTERAT I ON <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />'0 MOBILE HOME <br />o OTHER <br /> <br />D RESTAURANT <br /> <br />DESCRIPTION OF WORK ge:.-l t-A ~ <br />fo%')! B~' <br /> <br />BUILDING SIZE <br /> <br />& HEALTH DEPARTMENT APPROVAL <br /> <br />IE:- "?- ( S., (,..J C- P rz-.t;" C- ~ '('KN 01 ;..J c::- S ( [;-;J <br /> <br />. 5 C) t+r 3--0 ( <br />SQUARE FOOTAGE ~ 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 />~LDING <br /> <br />$ ~~ 06 0 <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />OGAS <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 AREAO YES 0 NO <br /><}l.f \ - r 2- L - i'S4t:J <br /> <br /> <br />BUJ:LDBR ~ COMPANY {1 rU C€- U~ {Aja-r--4- I <br />~ STATE CERT OR REGIST # C {S ,.. vu r 2 0 I ~ <br />SIGNATURE . CITY PROCESSING # '2.1 a 0 <br />^ IOe-r-J-r ~ CJ-e-......N-C-./\. ~ ..... a..J!l(;cI ~_ <br />***********************************************~**~**J;*** f'- <br /> <br />BLBCTRI:CI:AR <br /> <br />COMPANY. <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br />STATE CERT OR REGIS'J' #_ <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />***********~****************************************************** <br /> <br />,-,,----- --.,,-"-~ ---'''. " <br /> <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />HBCBARJ:CAL <br /> <br />***************************************************************** <br /> <br />OTBBR <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />