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<br />APPLICATION FOR PEmaT <br />CITY or ZBPHYRRILLS <br />BUILDING DBPARTMBNT <br /> <br />DMUZCIUVBD S / ~ 3 <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME <br /> <br />Ba..l NILc::.-n- ~ LII 1\....1 0 A , -:t:'" NC <br /> <br />PHONE <br /> <br />JOB ADDRESS 7 (p <-I 3 <br /> <br />G.-~ L<...- 11 <.- U 0 <br /> <br />L1 l SUf! t:.-A <br />LEGAL DESCRIPTION: LOT(S) -, BLOCK SUBDIVISION .C!U'(IL({lLlS c..(~.~ <br />PARCEL ID # :$.s. 2- 5 .2- J . 0 I I 0 - 00 00 D - 0 0 ~ 0 {OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: []NEW CONSTRUCTION <br />~IGN <br /> <br />[]ADDITION <br /> <br />[]ALTERATION <br /> <br />[] REPAIR" <br /> <br />[] INSTALL <br /> <br />[] MOVE <br /> <br />[] DEMOLISH <br /> <br />PROPOSED USE: []SGL FAMILY DWELLING <br />[] COMMERCIAL <br />~STAURANT <br /> <br />[]MULTI-FAMILY <br />[] INDUSTRIAL <br /> <br />[]# OF UNITS <br />[] SWIMMING POOL <br /> <br />[]MOBILE HOME <br />[] OTHER <br /> <br />& HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />IN<:::',A/-L- <br /> <br />P () L.-- C-- <br /> <br />S j &,.J <br /> <br />I:;: 0 It...- <br /> <br />( <br />Gi1. L( ~ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />I2"'BUILDING <br />r:::("ELECTRI CAL <br /> <br />$ <br /> <br />\~'CD'L. U ( T~ <br />"'U(~f", ~C- AMP SERVICE <br />I-'f- J:....<..... t!A::-1' t--, c... - Il-{ <br /> <br />[] FLORIDA POWER <br />0'/1+ ~ <br /> <br />[] <br /> <br />W.R.E.C. <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o PLUMBING <br /> <br />o MECHANICAL <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 />[] FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES 0 NO <br /> <br /> <br /> <br />T M..A G-LS. c;..^"".1 /-1 ( C. S r~./4 ( 7/tC-:J <br />COMPANY <br />STATE CERT OR REGIST # E 5 - 000 03 b I <br />CITY PROCESSING # <br />~ <br /> <br />BUILDER <br /> <br /> <br />.I N..A. ~ &,t.Ap H ( c.. 5 I' ;;;:C/I>r t.. TIC <br />COMPANY <br />STATE CERT OR REGIST # L.$ - <:I Q 0 03 b I <br />I~ PROCESSING # <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />***********.******************************************************* <br /> <br />SIGNATURE <br /> <br />Ct:)MPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />MECHANICAL <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />