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<br />APPLICM'IOR I'Oit -.aT <br />Clft 01' Dlltl!UiLLS <br />DUI:tD:D18 ~ <br /> <br />DQII Mc:avBD <br />~. 1aI9ID .... <br /> <br />OIIl'fER'S NAME ~~U~", 0\,-\ ~ RS <br />" ~ \ ~ &?~\'t ~ M~ <br /> <br />Ll!'.GAL DBSClUPTIONI LOT (S) \ C)Ol BLOCK SUBDIVISION <br /> <br />I?ARCEL ID It ~-.~~. ~\ ~ 00 CS-f\f"t-",C- (OBTAIN i'ROM PROPJ:RTV TAX Nll'I'T~21 <br />t OQI c.. <br />WORK PROPSImI DNEW CONSTRUCTION 0 ADDITION DAI.TERATION ~PAlR <br /> <br />JOB ADDREss <br /> <br />PHONB '119. a \ L I <br />\) ~ ~ "0 ~ <..\ C <br />A\9hA VI U~ ~~~'stl L <br /> <br />o INSTALL <br /> <br />Ds:um <br />PAOI?OSED USE;~GL FJ\HILY DWELLING <br />D COHMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />~TI-FAMILY <br />o INDUSTRIAL <br /> <br />Oft OF utnTS <br />o SWIMMINQ POOL <br /> <br />o MOBILE HOMB: <br />D OTHER <br />I <br /> <br />CJ Q!3TAUAANT . HBALTH DBPAR'rMENT APPROVAL . <br />DESCRIPTION OF WORR \<"t~'t 'tX~~\\~\ ~~,~ ~~af ~ l ~'\-frlLac,\ "- sLc~'fS <br />BUILDING SIZB SQUARl!: FOOTAGE ~ 00 Ot HEIGHT , c:;k "I ~ <br />RES IDBNTIAL I AT~ACH (2) PLOT PLAHS , (2) SE'l'S 01' BUILDING PLANS, (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SftS OJ!' BUILDING PLANS, (1) SIT ENERGY FONfs. <br />PROPERTY SURVEY REQUIRED FOR .lU.L NEW CONSTRUCTION. <br /> <br />~ BUILDING <br />o ELECTRICAl. <br />o PLUM8IlfG <br />o MIl:CHAfUCAL ~ <br />o GAS ~FING 0 SPECIALTY <br /> <br />$~"O <br /> <br />. . <br /> <br />PERMITS RBQOKSDD <br /> <br />VJU.UATIoN OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o Ji'LORIDA POWER <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANClAL INSTJl.LLATION <br />o OTHER <br /> <br />'rYPE OF CONSTRUCTION: 0 BLOCk <br /> <br />D FRAME <br /> <br />o STEEL <br /> <br />tJ OTHER <br /> <br />FINISHED FLOO~ ELEVATIONS <br /> <br />Is PROJECT IN FLOOD BONE ~D 'tES 0 NO <br /> <br />',... -. :'-:-'..' ~. - --- ,- _:"'n - '_''; .. .-:._~.. _ _.. <br />-, . . .- . ~ -~ _ T __. _ ~ ~ .. . <br />-~ . . . - ~- . .. L . <br />. - ..::::--,:::--:-: :.._'~:-. - :-~.. ~--. --_:-_- -~ ~ --:-: ,. .:;,.- ~"" .---;:::.:.. -:"..~... . ' <br /> <br />ItV%UlID. <br /> <br />COMPANY: <br />STATE CERT OR REGIST , <br />CITY PROCESSING /I <br /> <br />SIGNATURE <br /> <br />...**.***.*.*.*~***.....*.********....*******..********........**. <br /> <br />~CDJI <br /> <br />COMPANy , <br />STATE CERr OR RBGIST # <br />CITY PROCESSING ft <br /> <br />SlGIQ'l'URE <br /> <br />...**.*******.*.**~..****.*..**.****.**..**********.........**...* <br /> <br />PLOMBD. <br /> <br />COMPANY' <br />STATE CERT OR REGIST t <br />CITY PROCESSING # <br /> <br />SI GNA'l'URl!l <br /> <br />MIIe:BAlncar. <br /> <br />.*.*.**.**~*.**..*.......**********....*..**.**.*w***.**....****** <br /> <br />COHP1\}ly. <br />STM'E COT OR REGIST . <br />CITY PROCESSING # <br /> <br />SIGHATURI!: <br /> <br />.............**..****.......*.********...****...**..**.*****.*..* <br />. <br /> <br />0ftD <br /> <br /> <br />COMPANY Of'h "'l. , <br />STATE C~ OR REGIST If ~ 0 , <br />CITY PROcESSING # <br />'IJJ( <br />.******.....**** * ***.*.*.**.**..**..**~*~..*.************** <br />, ""I"",, Erl D ... <br />--!:I'''//fi:;:,.. . Eric D. Stanton' /fJ~""~:v.t-~ 'uVIYU._!N <br />.:-~~ "-~~. , ~*. -.g m,~ <br />ri 'i1 MY COMMISSION # DIJ085640 EXPIRE~..:J Januc <br />~" .~...~ January 22, 2006 -..j}';;...!!,-- IONDED1t.lIlUTRl", ,,, <br />86v!'ON "'~iH..t\I~- BONOEDTHRUTRg~wg.O ^rr~.t1\' ~VvZ:6 0UOZ '8I'H~ <br /> <br /> <br />S1 GNATuRl!l <br /> <br />Z 'd <br />