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<br />APPLiCATiON FOR PERMiT <br />CITY 01' ZlI:PRYRHiLLS <br />BUiLDING DEPARTMENT <br /> <br />"-IS-o ~ <br />DATE RECEiVED oL ---- <br />PLANS REViEW I'BE <br /> <br />OWNER'S NAME <br /> <br />~ u\\-{ <br />"(2'5 <br /> <br />~Re.~(.{ <br />q~ STREf. r <br /> <br />PHONE 8r~ -It&- 213~ <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID It OZ-Z".ZI.OI-bo- t)C>2oo -60'10 <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br /> <br />[J ADDITION <br /> <br />[JALTERATION <br /> <br />[J REPAIR <br /> <br />I5-INSTALL <br /> <br />[J SIGN <br /> <br />[J MOVE <br /> <br />[J DEMOLISH <br /> <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />[JMULTI-FAMILY <br />[J INDUSTRIAL <br /> <br />[J1t OF UNITS <br />[J SWIMMING POOL <br /> <br />[J MOBILE HOME <br />[J OTHER <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK .f"t:. NCe.... <br /> <br />s-e:, / rT <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 />~UILDING <br />[J ELECTRICAL <br />[J PLUMBING <br />[J MECHANICAL <br /> <br />PERMITS REQUESTED <br /> <br />$ .s; ~r2'7 - <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />[J FLORIDA POWER <br /> <br />[J <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[J GAS <br /> <br />[J ROOFING <br /> <br />[J SPECIALTY <br /> <br />[J OTHER <br /> <br />TYPE OF CONSTRUCTION: [J BLOCK <br /> <br />[J FRAME <br /> <br />[J STEEL <br /> <br />[J OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[J YES [J NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <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 REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />* * * * * * * * ** *,* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />SIGNATURE <br /> <br /> <br />COMPANY Bcttcf{Y\/ <br />STATE CERT OR REGIST <br />CITY PROCESSING # <br /> <br />Fevc.b -::r/0~ <br /># S9-2~/779<-j <br />Itpql <br /> <br />OTRBR <br /> <br />***************************************************************** <br />