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<br />n 0 L z....s <br /> <br />788-5262 <br /> <br />lO/12/19c9 04:21:38 PM <br /> <br />F. 1 <br /> <br />..... -~.)U~I;::;n5 <br /> <br />APPLICATION FOP. P'E:RKIT <br />CITY or tKPRTRBILLS <br />BUILDrl'm DJr.PAR't!IIXNT <br /> <br />.- <br /> <br />DAn: UCErvxn !J .... ~I ~ 0 ~ <br />PLANS RZVIE'If nm 1I/;4 <br />IV <br /> <br />OWNER' 5 NN'.E <br /> <br />C l T'( of -z-f'PH y. irttU.5 PHONE <br />~~-~~9P.:5-//S-~-~,y are . <br />-,.,...., ~ <br /> <br />IV I A- <br /> <br />JOB ADDRESS <br /> <br />LEGAL D~SCRIPTION: LOTtS) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # H -?'lp~.;;2l-0oI0-lS IOO-OILlO <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br />o 51 G!I <br /> <br />o ADD1TION <br /> <br />rOIlTATN !'"ROM PROPF.RTY TAX NO'TH'''l <br /> <br />OALTERATION 0 REPAIR ~STALL <br /> <br />o MOVE <br /> <br />o DEMOL:;:SH <br /> <br />PAOPOSED USE: aSGL "AMILY DWELLING <br />~COMMERCIAL <br /> <br />OMULTI-E'AMILY <br />O!NDUSTRIl\L <br /> <br />O. OF UNITS <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />o SWIMMING POOL <br /> <br />BUILDING SIZE <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />-:r eV'S.'TA<-L 1=\((~ A~ S'(Si"t M <br />SQUARE roOTAGE ~, g70 <br /> <br />HEIGHT <br /> <br />DESCRIPTION Of WORK <br /> <br />a BUILDING <br /> <br />s~ I (02S0~ <br /> <br />PLANS, (2) SETS OF BUILDING PLANS, (1) SET eneRGY FORMS. <br />OF BUILDING PLANS & (II S~ ENERGY FORMS. ~p <br />REQUIRED fOR AI.I. NEW CONSTRUCTION. QLY" <br /> <br /> <br />PEIlMITS REQUESTED ~ ,vr<--- ~ <br />VALUATION OF'TOTAL CONSTRUCTION ~ <br /> <br />1 6.L t? <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />^T'l'7\CH (2) PLOT <br />ATTACH (3) SETS <br />PROPERTY SURVEY <br /> <br />a ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />/ffl <br />~~ <br />'1~#Jt 5~O~, <br />/~ <br /> <br />a PLUMBING <br />a MI!:CHANlCAL <br /> <br />s <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />a GAS <br /> <br />a ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: a BLOCK <br /> <br />o FAAJoIE <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISIlED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN fLOOD ZONE AREAO YES / 0 NO <br /> <br />SIGNATURE <br /> <br />'-:' _-,~;: :;;;;.':1 ~:!' ';1 , ,..,.......... <br />." ,. "~/;':;::~:':T;: };;;!H~iil~J <br />/ <br />I <br />I <br />/ <br />/ <br />...+?.w..........................._4+......................,*+... <br /> <br /> <br />" <br />-:; i..L <br /> <br />lW:ILDItR <br /> <br />COMPANY <br />STATE CERT OR REGIST <br />CITY PROCESSING W <br /> <br />! <br />i <br />.............+..+.+.+++.*~+......._........+......++....~..+.+.... <br />i <br />! <br /> <br />COMPANY <br />STATE CERT OR REGIS7 ~ <br />CITY PROCESSING # <br /> <br />j <br />/ <br /> <br />ELECTIUC:IM <br /> <br />SIGNATURE <br /> <br />PLUMBER <br /> <br />SIGNATURe: <br /> <br />COMPANY I <br />STATE CERT OR REGIST ~ <br />CITY PROCESSING # ! <br /> <br />......................+++.......++................... ............ <br /> <br />MECIlNfI CA!. <br /> <br />COMPANY <br />STATE CERT OR REGI T # <br />CITY PROCESSING ~I <br /> <br />.................................................;/............... <br /> <br />. v-e. MPANY Co t'\\ (Vt.e rei cJL -h vc. ""- '-0 ~lA..IA <br />ATE CERT OR REGIST # e of 0000 -r l?S <br />ITY PROCESSING ~ . ~ <br /> <br />-_.......................................~ii::. <br /> <br />SIGNATURE: <br /> <br /> <br />0'l'HER <br />