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<br />APPLICATION FOR PEmaT <br />CITY OF ZBPRYRRILLS <br />BUILDING DEPARTMENT <br /> <br />DATE RECEIVED <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME <br /> <br />r!v/~ e l~{f?t W <br />-57~ fiWn/Nh 'Rd. <br /> <br />PHONE 7Bl/-bd-~7 <br />? hllif R ~~0:J- . <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: []NEW CONSTRUCTION <br /> <br />[] ADDITION <br /> <br />[]ALTERATION <br /> <br />1 REPAIR <br /> <br />[] INSTALL <br /> <br />PROPOSED <br /> <br />[] SIGN <br />USE'~Gi FAMILY <br />COMMERCIAL <br /> <br />[] MOVE <br /> <br />[] DEMOLISH <br /> <br />DWELLING <br /> <br />[]MULTI-FAMILY <br />[] INDUSTRIAL <br /> <br />[]# OF UNITS <br />[] SWIMMING POOL <br /> <br />[] MOBILE HOME <br />[]OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />~ t!if2J-f- <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 />PERMITS REQUESTED <br /> <br />[] BUILDING <br /> <br />$ 3. qOG <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[] ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[] FLORIDA POWER <br /> <br />[] W.R.E.C. <br /> <br />[] PLUMBING <br />[] MECHANI CAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[] GAS <br /> <br />[] ROOFING <br /> <br />[] SPECIALTY <br /> <br />[] OTHER <br /> <br />TYPE OF CONSTRUCTION: [] BLOCK <br /> <br />[] FRAME <br /> <br />[] STEEL <br /> <br />[] OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES <br /> <br />[] NO <br /> <br /> <br />BUILDER COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />************************** *************************************** <br /> <br />ELECTRICIAN COMPANY <br />STATE CERT OR REGIST # <br />SIGNATURE CITY PROCESSING # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />**********~******************************************************* <br /> <br />MECHANICAL <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNA'IURE <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />