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<br />OMPANY FAX NO. 9043574861 <br />NOV-14-03 FRI 04:55 PM THE HASKE~J"_Q~.__........w.l.l~ ~~~4 APPLICATION <br />BUILDING lJSPARTMENT 5335 8th Stregt, Zephy"h.i~J."', n :3:3542 <br />813-7aO-0020 FAX;S13-7S0-0021 <br /> <br />P. 03 <br /> <br />DATE RECE IVED- ~ <br />p~S REVIEW ~E <br /> <br />OWNE~' S NAM"---A'G:5TLE V<?fT,e;eS #OIRT-'I A.HE~k:/I-) r4/~ P80"" &/!,"-;>g3"- /'7;;--1 <br /> <br />JOB ADDRESS '13SL:> 207'1-{ S~~eET 2.l:'r:"/fYJ<HILL5 ~~ 3-:;540 <br />. / <br />LEGAl,' DESCRIP'T'TON: LOT($) .,A".;4- BLOCK .4//1- SUBDIVISION #/f <br /> <br />PARCEL 1D * -B -2,6- 2.1- a:>;;.O - 034</(;0 -co.2,o . <br /> <br />WO~K PROPSED: CJNEW CONSTRUCTION <br />OSrall1 <br /> <br />o ADD:(TION <br /> <br />CORTAIN FROM PR~p~~TY T~~OTI~F.} <br />~LtERATION 0 REPAIR 0 INSTALL <br />o DEHOr..ISH <br /> <br />o t'lOVE <br /> <br />PROPOSED USE: []SGL FAMILY DWELLING <br />U COMMERC rAt <br /> <br />DHOtTI - FAMU Y <br />o INDUSTRIAL <br /> <br />0# or UNITs <br />o SWU1MING POOL <br /> <br />n HODILE HOM]!; <br />o OTHER <br /> <br />o R~S'fAOMNT & HE~LTH UEPAATMENT APPROVAL <br />DESCI\1PTION OF WORt( A/O/Z.TH) .E';4s;;; AA/tfJ W,F-S/ 5T~ 0</l1#'#--= :r.u"'4/"-LC~'6~?"$ <br />BUILDING SIZ~ -- SQUARE FOOTAGE ijEIGHT _ <br /> <br /> <br />AT'l'ACIi (2) ?1;"OT PLlI.NS & (2) SETS Of SUILDING PLANS & (1) SET ENERGY fORMS. <br />ATTACH (3) SETS OF BUILOING PLANs & (1) SET ENERGY FO~IS. <br />PROPERTy SURVEY ~EQurkED FOR ALL NEW CONSTROCTION. <br /> <br />PERMITS REQUESTED <br />... <br /> <br />$~ <br /> <br />VALUATION OF TOTAL CONSTRUCTIO~ <br /> <br />o ELECTRICAL <br /> <br />Ju'1P :S~l<.VICE <br /> <br />o FLORI DA POWER <br /> <br />o W.R.E.C. <br /> <br />o l?LUHBIN~ <br />o MEcnAN:rCAL <br /> <br />$ <br /> <br />[:J GAS <br /> <br />[J ROOFING <br /> <br />o SPECIALTY <br /> <br />VALOATlON or MEcaA~CIAL rNSTALL~TrON <br />~HER <br /> <br />TYPE OF' CONS'l'RtJcrrON: 0 BLOCK <br /> <br />o FRAMf: <br /> <br />o S'I'E~L <br /> <br />[3'C)'rRER <br /> <br />frNrSfiED FLOOr<.. ELEVA'I'IONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br />L~"",', <br /> <br />, <br /> <br /> <br /> <br />"'-'xu>",> ~ ' COMPANy--$Jr I;/4:;YB~" <br />' . S:L'ATE CERT OR. REGIST * ~ l"Y> ~~'75 <br />SIGNATURE~, ""~~" ern >ROCE03XNG * ~ <br />sf. C. ./ <br />" ................................,...................,..~. . . . <br /> <br />ELE~~RIC!AN COMPANY <br />STATE CERT OR REGIS'!' * <br />CITY PROC~~~!NG # <br /> <br />. .. . I , <br />- <br /> <br />.:.. I, <br /> <br />SIGNATURE ~ <br /> <br />l'LUt-mE!l. <br /> <br />*~***~***k***~*******************************r**w*******~***.****~ <br /> <br />COMl?'ANi' <br />C~~~~ ~~o~ ^b Q~~TO~ ~ <br />