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<br />OWNER'S NAME <br /> <br />f<D w f <br />13~7alD <br /> <br />'1 ~JA}uD.e~ t<oLOSToW <br />Vi.).. lc R)0 C He . <br /> <br />PHONE <br /> <br />8J3-779-- ~8~'! <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEl:(. ID # 01- "':2~~ :J/-OOJC-OOODO -oo<fO <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE\ <br /> <br />o MOVE <br /> <br />)(ALTERAT ION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br />OSIGN <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o ADDITION <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK ~~~l N) ~(Asftc.. ~ UJ 00 W -4 't)1oR <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 />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br /> <br />PERMITS <br /> <br /> <br />X'SUILDING <br />jl(ELECTRICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL <br />o OTHER <br /> <br />$ <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />-r:. <br />f <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES ~NO <br /> <br />BUILDER <br />SIGNATURE ~ ~ <br /> <br />cONT1tAC-ro~.../S:ECTIOl{ <br />COMPANY Home OWr0G rc <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRIC~~ ~ <br />SIGNATURE <br /> <br />COMPANY ~ jrJ p t:J"" her <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNArI'URE <br /> <br /> <br />***********~:********** <br /> <br />****************"ii!:******************* <br />V>c- COMPANY h'7~he r <br /> <br />, ) STATE CERT OR REGIST # <br /> <br />MECHANICAL <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />