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<br />cJ:n 011 UPB%UJ::LLS >>BJ1IaT APPLI~l:OH <br />BfJIU)DfG DBl'ARDGDa' 5335.M> Stlftflot, &.pIryEhilu, IT. 33542 <br />813-7110-0020 1"JlX:813~'78o-0021 ItJ I/s /0..~ <br />tlAft ll&CIIXVIW, I f <br />~ UVIn... - <br /> <br />::::' &Hg;~/I RS:;~~r{'Ud:;; <br /> <br />L&GAL DESCRIP"~ON: LOT(S) ~r BLOCK~<8baDIVISION 0 ~-;~ <br />PAI\ClitL In I C) "'3~___ IOR'I'Jl.TM FROM PIl.OP __ NOTTCl:1 <br /> <br />WORK PROPSEO: ClNew CONST1\UCTION <br />OSIGN <br /> <br />o ADDl'rION <br />o MOVE <br /> <br />DAL1ERATIOQ )( REPAIR <br />o DDIOLlSH <br /> <br />o ItlSTALL <br /> <br />PROPOSED USE: OSG!. FAMILY DWELLING OHOLTI-FilMILY <br />OCCHfDClAL 0 INDUSTRIAL <br /> <br />0, OF UNITS <br />OSWIMMING POOL <br /> <br />Cl MOJlILE: HOME <br />o OTItER <br /> <br />o IlESTAU1U\Ht I. HEAL'1'H DEPAft1'H!:N'1' APPROVAL <br />DESCRIPTION OF WORK ~~6f(. UnJ+ ChaYt:J~ 00T <br />BUILDING SIZE SQUARe I'OOTAGE HEIGHT <br /> <br />RESIDENTIAL I A'J"l'ACH (2) PLOT PlANS , (21 SETS OF BOILl>nte li'tANS , (11 SET ENERG"'{ FORMS. <br />COMMERCIAL: ATnCl{ (:'I) SP:rS Or 9U1LOIOO PLANS, (1) St'!' ENERGY FOIIMS_ <br />t>ROPEMY SORVEY REQUIRED FOR J\.LL NOf CONSTRUCTION. <br /> <br />PDMITS RIIQtJBS'BD <br /> <br />o BUILDING <br />o ELEC'l'IllCAl. <br />o PLtlMBING <br />X MECHANIO\.L <br />o GAS 0 ROOFING <br /> <br />~ <br /> <br />VALtJATIotl or l"OTAL CONS'1"IUJeTIOU <br /> <br />AMP SEIlVICE <br /> <br />o rLOIUDA POWER. <br /> <br />o W.R.E.C. . <br /> <br />! l/ <br />jJ-~ <br /> <br />,-/ <br />-. --.-- ....----'" <br /> <br />,/ <br /> <br />$ /~~O <br />o SPECIALTY <br /> <br />i <br />.,/'" <br /> <br />VALOATION OF HECIlANCIAL INSTALLATION <br />o O'l'RER <br /> <br />TYPE OF CONSTRUCT!ON: 0 BLOCK <br /> <br />o FIWU; <br /> <br />o STEEL <br /> <br />o OTHEa <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS! Pll.OJEC'l' IN FLOOD z<lNE A1U:AO YES 0 NO . <br /> <br />I: <br /> <br />. . <br /> <br />_. <br /> <br />IJUD.DJ:R <br /> <br />S!GtlATORE <br /> <br />COMJ.>Am' <br />STATE CER'l' Ol\ '-'SGIST . <br />CITY PROCESSING ______ <br /> <br />.7.**.*.**.._**..*_*.........*..<<.~.~..*.~.*.*~**.*.....***~*_.*.* <br /> <br />JU.SCftJ:CIAN <br /> <br />COMPANY <br />STAn: CEllT OR REGIST I <br />CITY PftOCESSING , <br /> <br />SIGNATURE <br /> <br />.*.........*~...~....**.*..~....**....*.,..*..........*...-.....*. <br /> <br />PLllWBIlR. <br /> <br />ISCJlAMlCAt. <br /> <br /> <br />COMPAliIY <br />STATE CERT OR REGlST I <br />CITY PROCESSING . <br /> <br />SIGNATURE <br /> <br />SIGIiATtJQ5: <br /> <br />nu.h.h..h.hhh.U~;~;;;.;;.~fi;;..i-*.~~ fs G::. , <br />A'l'E CERT OR REGIST . ~ _ _~ <br />CITY PkOcESSING . <br /> <br /> <br />..*~..**.*.**..*.*...........**..................*~.....~+..**..* <br /> <br />O'mIIR <br /> <br />COMI?ANY <br />STATE CUT OR REGIS\' , <br />CITY PROCESSING t <br /> <br />SIGNATURE <br /> <br />**.*.*.*w.............*.*.~.......**..~..*..*.**.*..*~***._****** <br />