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<br />OWNBR' S NAMB -.B.I y Uo H l.\ 11 t /1$ <:Ii:) <br />.TOB SITE ADDRESS q <t '-I , 'b r'" . <br /> <br />LEGAI~ DESCRIPTION: LOT(S) I 4't'1 S BLOCK' 1 <br /> <br />PARCEL ID # /i.{. J 6. ';).1- DO} 0- 0 J 10'0- OJ.3 () <br /> <br />CITY OF ~" .dEDI'.f APP.........CATION -U- /L(li-/ <br />BUILDING DBPARTHlDn' ::iHS Sth STREET ZEPHYRnrLLB, PL 33540 <br />PhoneIB13-780-0020 PaxIS13-780-0021' <br />DATB RBCBIVBD <br />PLANS REVIBW PBB <br /> <br />PHONE CONTACT 7'::1- ~ 5/ <( <br /> <br />SUBDIVISION yt1\)~rese (st A Jdit,' o,J <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />~ INSTALL <br /> <br />[JSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: [JSGL FAMILY DWELLING <br /> <br />[JMULTI-FAMILY <br /> <br />[J# OF UNITS <br />[J SWIMMING POOL <br /> <br />rstMOBILE HOMR <br />o OTHER <br /> <br />o COMMERCIAL <br /> <br />[] INDUSTRIAl, <br /> <br />DESCRIP'l'ION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />~/ool LV A;~('~ ~ ~b~~;", /?71!'h1//'/I"'~ <br />/ / , <br />SQUARE FOOTAGE;? "-I 0 HEIGHT <br /> <br />BUILDING SIZE <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />~TTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />AT1~CH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />[J BUILDING <br /> <br />$ <br /> <br />PERMITS REQUBSTED <br />b~SO. IJ9 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[J FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />[J PI,uM8ING <br /> <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />!)rROOFING <br /> <br />o SPECIALTY <br /> <br />[J OTHER <br /> <br />TYPE OF CONSTRUCTION: [J BLOCK <br /> <br />o FRAME <br /> <br />[] STEEL <br /> <br />W O'l'HER <br /> <br />FINISHED FJ.QOR ELEVA'!'IONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br /> <br />BUXW_ ~ / <br /> <br />SIGNATURE ~~ . <br />.-. <br /> <br />COMPANY :x I) lJ " nC ," 6/ e. A s; 5 () c.. <br />STATE CER'!' OR REGIST # C c c. 0 L( 9 3 b 7 <br />CITY PROCESSING # -3 0 CJ <br /> <br />**********************.*.*...*.**.......***.................**.*** <br /> <br />BLECTRICIAN <br /> <br />S lGNA'I'URE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />.*...*****.*.****.***...****.~*...**.*********.*.***..***.*..***** <br /> <br />PLDHBBR <br /> <br />COMPANY <br />STATE CERT ORREGIST # <br />CITY PROCESSING # . <br /> <br />, " <br /> <br />SIGNATURE <br /> <br />KBCHAHICAL <br /> <br />*******.*.******************..*..***************.***.***.********* <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />..**.**..**.**..*..****.*.******.**.****.***.....*..****.******** <br /> <br />OTHER <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />********************.*********..*..**.**.***.***.~.***********.** <br />