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<br />APPLICATION FOR PERMIT
<br />CITY or ZBPHYBHILLS
<br />BUILD:ING DEPARTMENT
<br />
<br />DATE RECEIVED / IJ -- ;;l t.; -0 !
<br />PLANS REVIEW DE
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<br />PHONE 5b 7-'7~9 "J_
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<br />OWNER'S NAME
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<br />LEGAL DESCRIPTION: LOT(S) BLOCK
<br />'.,PAR~EL,~D';' "64, ~s-- ?/-()O:::JO-Cb?PO.,CC:20 {OBTAIN FROM PROPERTY T~ NOTTCF.\
<br />
<br />WORK PROPSED: ~ CONS'.l'RUC'.l'ION.
<br />....1-
<br />
<br />o ADDI'.l'ION
<br />
<br />OALTERATION
<br />
<br />o REPAIR
<br />
<br />o INSTALL
<br />
<br />.. "".
<br />
<br />OSIGN
<br />PROPOSED USE:OSGL FAMILY DWELLING
<br />
<br />o MOVE 0 DEMOLISH
<br />Ott!Gi,TI-FAMILV 0" OF UNITS
<br />
<br />.1 \.
<br />
<br />o COMMERCIAL
<br />
<br />o INDUS;l'RIAL
<br />
<br />o SWIMMING POOL
<br />
<br />o MOBILE HOME
<br />. ,
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<br />o OTHER
<br />
<br />h ,'.': . D RESTAURANT &. HEAL'fn DEPAR'fMEN'f APPROVAL
<br />DESCRIPTION OF W. O~K, ~ (..{ " ) J I .: f., I.{ ~p2 ~"(1+ ~V \ \d {. w\~
<br />BU~~~IN~. SIZE 'PI! -#1/ )(~() SQUARE FOOTAGE f?-/ /, ~ r HEIGHT d/t
<br />RESIDENTIAL: ATTACH (2) PL01' PLANS & (2) SE'rs OF BUILDING PLANS & (1) SET ENER~Y FORMS.
<br />COMMERCIAL: ATTACH (3) SETS OF BUILDING. PLANS & (1) SET ENERGY FORMS.
<br />PROPERTY SURVEY REQUIRED E'OR ALL NEW CONSTRUC'rION.
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<br />~ILDING .
<br />~LECTRICAL
<br />df;LUMBING .
<br />~CJIANI~ $
<br />o GAS'. ,f ~FING 0 SPECIALTY
<br />T~~it:~F ~~~~~;~UCTION: ~~~K .
<br />
<br />PERMITS REQUESTED
<br />
<br />$
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
<br />
<br />~FLORIDA POWER
<br />
<br />o . W.R.E.C.
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<br /> VALUA'l' I ON OF MECIIANCIAL INSTALLATION
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<br />0 O'fHER
<br />0 FRAME 0 STEEL o O'fHER
<br /> IS PROJECT IN FLOOD ZONE AREA..O YES ~
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<br />FINISHED,FLOOR ELEVATIONS
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<br />COMPANV-F, '1 S + C 145.5 f: I ~c.:f ~.
<br />STATE CERT OR REGIST 1# bc:o ~~ D
<br />CITY PROCESSING 1# , 'I ~
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<br />SIGNATURE
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<br />STATE CERT OR REGIST 1# JJt~ 7<i ~
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<br />SIGNATURE
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<br />SIGNATURE
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<br />COMPANY
<br />STATE CERT OR REGIST 1# I
<br />CITY PROCESSING " . .t:;'71::>0
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<br />COMPANY
<br />STATE CERT OR REGIST #
<br />CITY PROCESSING #
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<br />SIGNATURE
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