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<br />APPLICATION FOR. PERMIT <br />CITY OF ZBPRY.RRILLS <br />BUILDING DEPARTMENT <br /> <br />,l~rfJ?J ~ -~ r -q ~.. t.!J <br /> <br />~-~-..- - <br /> <br />t::" -30 -- tJ,~ <br />DATE RECEIVED ...J <br />PLANS REVIEW FEE <br /> <br />0\,\ \ b CA \A~e-r <br />JOB ADDRESS L\. Cb '-\'1 t\\" \~ a f\- V;;-^ <br />LEGAL DESCRIPTION: LOT(S) :5 -...., Cc <br /> <br />OWNER'S NAME <br /> <br />PHONE <br /> <br />l~1- (j.-ll3 <br />336Y~ <br /> <br />7 e ,~\\~ \'~i\ \<, F l _ <br />\ ' <br /> <br />SUBDIVISION <br />J3-(j.tp;;l\ - :::>O\Q - JOQ()Q -. OQ5U <br />PARCEL ID # 1.?.J'd.l,,-J.\~O()\()-()\)()QD-O()lo~)f {OBTAIN FROM PROPERTY TAX NOTICE\ <br /> <br />BLOCK <br /> <br />WORK PROPSED: ONEW CONSTRUCTION IStADDITION OALTERATION o REPAIR o INSTALL <br /> OSIGN o MOVE 0 DEMOLISH <br />PROPOSED USE: OSGL FAMILY DWELLING OMULTI-FAMILY 0# OF UNITS o MOBILE HOME <br /> o COMMERCIAL ~NDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK \i\~~\ bL,'-v~\~\ (\ 'f <br />BUILDING SIZE ~)-~ '/..... ,00 SQUARE FOOTAGE (0 (Soo <br /> <br />HEIGHT <br /> <br />\ q \=t <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ 12:0,000 <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 />o GAS <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 />rg' STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br /> <br />BUILDER. COMPANY \\Q.,e.. t.u"\\'CAC-\\Y\~dlc{'C. <br />~ STATE CERT OR REGIST # L- G c... __ _ ~S <br />SIGNATUR__r ' -- - CITY PROCESSING # ~ <br /> <br />. . H* H* HH* *HH *H H HH H H* H* H *H*HH* H H* * *H H *H H:t'!ftt f'PJ'v/P-..t!;: <br /> <br />BLBC'1'R.ICIAH'\ COMPANY 'btJl.A.~\4~ 1:= ) ~ L-t-Y"\'c.. Ir)c.. _ c::.. <br />- ~). (). . () ~ ~ () STATE CERT OR REGIST # E ~ 0 Db (~55 d. <br />SIGNATURE~.~ ~ CITY PROCESSING # ~ iu ~ 0 1::0 <br />....- v__/~ r, <br />* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * m""'IiW'li7i''I..''''I<------ - . <br /> <br />'- COMPANy1J~(\"'\~:J L. L'0; \\.ic:u~Y-:, ~\\"'J'Y\b,n6 <br /> <br />STATE CERT OR REGIST # c... F c:.. \ l.\ &5l..,D a <br />CITY PROCESSING # /9 ctlD <br /> <br /> <br />PLUMBlI:R. C\\ - <br />~TU~lJ~ J- (JJ~ <br /> <br />**********~******************************************************* <br /> <br />Hll:CRAHlCAL <br /> <br />COMPANY: <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />OTRll:R. <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />