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<br />- .-..---~. _.._.._...~_.-----~ <br /> <br />; :. <br /> <br />0"7 J II <br />fj: (rill'S <br /> <br />APPLICATION FOR p~T <br />CITY OF Zm?HYRJrILLS <br />BUILDING DEPARTMENT <br /> <br />DATE RECEIVED ..s-- .../ /-t] 'I <br />PLANS REVIEW FEE <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />Z Ct cka.rtA. 6 Cz <br />Lo f Lf3 <br /> <br />fs <br /> <br />P l'..RCEL I D # () ')-.-)..t.R - ;)J - 0 () /d - <br /> <br />yCA-.C/ <br />i/IA let( tr <br /> <br />Lf'r, <br /> <br /> <br />NE <br /> <br />--) <br /> <br />/ <br /> <br />OlrJNF..:R' S NAME <br /> <br />JOB ADDRESS <br /> <br />BLOCK <br /> <br />o <br /> <br />. "' <br /> <br />SUBDIVISION/V lit{ q -e ere) tl -€.. ?i< I <br />.- <br /> <br />CJO()t)o - CJY50 <br /> <br />(OBTAIN FROM PROPF.RTY TAX NOTICEI <br /> <br />WORK PROPSED: [)NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />l1'I N STALL <br /> <br />Os I GN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />/ <br />QI MOBILE HOME <br /> <br />o OTHER <br /> <br />BUILDING SIZE <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />II &/AJ ()II;) 61 'Ie !Io }-r1 e '-p )CL ~ e f'/'L ef/lf- <br /> <br />dCj Y 5 :J-. SQUARE FOOTAGE /;).. tjF' <br /> <br />HEIGHT <br /> <br />DESCRIPTION OF WORK <br /> <br />('5' '.' , <1 <br />I 0(../, <br /> <br /> <br />PERMITS REQUESTED <br /> <br />ngSIDENTIAL: <br />COMM~:RCIAL: <br /> <br />ATTACH (2) PLOT <br />.l\.'l'TACH (3) SETS <br />PROPERTY SURVEY <br /> <br />/ <br /> <br />J/~tq~ <br /> <br />r!1/Bll ILDING <br /> <br />rri EI.ECTRI CAL <br />rrf' Y.UMBING <br />~ MECHANICAL <br /> <br />$ <br /> <br />I <br />1(5, t)tI~/ J-&tiO <br />/50 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />FLORIDA POWER <br /> <br />'0 <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL <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 />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FIN1SHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE <br /> <br />SIGNATURE <br /> <br />/" <br />, ) ,. <br />~ Y1!trrn- <br /> <br />~tgJ:{,~:t~ie~J;~ <br />ff!t h-/I ~ / / <br />COMPANY 'ZLrs. r ~I S /Jtl/Se~ <br />STATE CERT OR REGIST #..z:: 'tJ~ '3tJ7 <br />CITY PROCESSING # <br /> <br />.//( <br /> <br />L <br /> <br />BUILDER <br /> <br />***********~********..***********.******************************** <br /> <br />ELECTRICIAN <br />-~L~ <br />SIGNA'ruRE <br /> <br />COMPANY DlJJ;;/,/11 c714r~n :Ses- <br />STATE CERT OR REGIST # C /? J')~CJCJ '5~ 7 <br />CITY PROCESSING # <br /> <br />.._~ **.* * **.. * * * * ** k * Ie ***** ** * ***** ** *.. ** ********* * Ir ******** ********.. <br /> <br />COMPANY j17(,-r shJ!. '?!!e(~s j1), j/, S~ <br />STATE CERT OR REGIST ff ~lItJotJO 301 <br />CITY PROCESSING " <br /> <br />" I <br />PLUMBER/ i ,- <br /> <br />SlGNNrU~"k~/l~ <br /> <br />./,,,_. <br /> <br />SIGNATURE <br /> <br />*** * * ** * * * ** ** * ** *.. *. *... **.... * * * **.... * ** ** * ** *~.... r.* ** *1*,*** * ~ **** ** It * <br />COMPANY !..-/Ol;./h / ~,I /J-tv 5'yS~-S <br /> <br />{'J \ ~ ~ i 1 () /I STATE CERT O~ REGIST " (!.H{!C) 5 7/1 s:- <br />~ ~ CITY PROCESSING # <br /> <br />UECHANlCAL <br /> <br />*********************************~**~**************************** <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />OTHER <br /> <br />**~******~.************~~!**********k***********.*******.A*******~ <br />