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<br />UPLICATIOlf roa Rl\lD:T <br />CITY or UPIlDHILL9 <br />BUILDING DEPU'l'WBlft <br /> <br />DM'& MCl:I'YKD <br />PLalIlI RZVUIf I'EB <br /> <br />DRAGtOtJ Btl r-F€r <br />OWNER'S NAME JIMtYI '/ '1()V~C3J <br />JOB ADDRESS, 5Y20 GAt.-L f3:>L-\I D <br /> <br />PHONE 1lD~ - 32-iU <br /> <br />LEGAL DESCRIPTION: LOT IS) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br />WORK PROPSED: DNEW CONSTRUCTION <br />OSIGN <br /> <br />10"TATN FROM PROPF.RTY TlUC NO'I'TCEI <br /> <br />o ADDITION <br /> <br />pIl.LTEM'I'ION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />]i4COMMERCIAL <br />CJ RESTAUWWT , HElU.TH DEPARTMENT APPROVAL <br />_p...~ fOR.. u)O~1 Wll-t \ l.~~'1tfS, 7, ~tf.croK!tS, Smo~, ~E.. <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />D SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <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, (11 SET mfERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANIC1U. <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />l( GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />$ <br /> <br />TYPE OF CONSTRUCTION: tJt BLOCK <br />FINISHED FLOOR EL~TIONS <br /> <br />o FRP.ME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />o NO <br /> <br />;,~~]a~~it;~~i~~;;:~ <br /> <br /> <br />-.... .. ~ <br /> <br />! .~~~~~~...fO:;;~~ <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />BUILDBa <br /> <br />SIGNATURE <br /> <br />.**...***..................................*..........*******--*** <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING . <br /> <br />J:LEC:'1'IU elM <br /> <br />SIGNATURE <br /> <br /> <br />........................................ <br /> <br />PLOYBBll <br /> <br />=WARY ~R>m"'~ W ' <br />STATE CERT OR REGIST II t;j '1/fJJ'5 <br />CITY PROCESSING # <br /> <br />COMPANY <br />STArE CERT OR REGIST # <br />CITY PROCESSING . <br /> <br />YBCIIlUt:ICAL <br /> <br />SIGNATURE <br /> <br />*.*******.*.............................**....................... <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING . <br /> <br />0'1'IIJ:P. <br /> <br />..........................**..................................... <br /> <br />~ 'd <br /> <br />LO~O'ON <br /> <br />SllIH~AHd3Z jO A1IJ <br /> <br />t'ld91:E tOO~ 'IE'uer <br /> <br />c:: e13ed <br /> <br />:s...e~SeI/\lS8'E) <- <br /> <br />:I/\ldec:::e: <br /> <br />~Ol ~e:1 ~ <br /> <br />:pa^.eoe\:l <br />