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<br />, 'FROt1 :MILEAR
<br />
<br />FAX NO. :3525674454
<br />
<br />Oct. 29 2004 08:02AM P4
<br />
<br />APPLICA'rIOlI I'Oa PBRHI'r
<br />CITY oJ' DPHYIUI1:LL9
<br />, BUILDDJU D.BPAR'rIIBNT
<br />
<br />rn e ,
<br />
<br />it 3~Llq
<br />
<br />DAD UCBIVBD
<br />PLUlS. lQIVIn I'BZ
<br />
<br />OWNER~S NAME \1C(Y\e.5\.\-~ 1L\Jelb~n+e 'Bea..\ ~ .. PHONE.8B}~ -l~34
<br />'f\."l~U'r\s ) \ no. .. . Z V\bw~ ~. \''''' <r:: I ~ .., ~1 I ,.....
<br />JOB ADDRESS 3gG:,~O ~~ A.Ne..n\1.~ ~ rt:~., ~) ~'-' D.".::;l'--t'\J
<br />
<br />LEGAL DESCRIPTION: LOT(S) \5 ~ \ LQ BLOCK ~ SUBDIVISION m~()v-es Md\+;b()
<br />
<br />PARCEL ID # \4"'~~.d\-00\{)...lJCY~~- t)\S \ (OBTAIN FROM PROPF.RTY TAX NOTrCE)
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<br />WORK l'ROPSED: ONEW: CONSTRUCTION
<br />o SIGN
<br />
<br />o ADDITION
<br />
<br />DJ,U,TERATION
<br />
<br />If REPAIR
<br />
<br />o INSTALL
<br />
<br />, '
<br />
<br />o MOVE
<br />
<br />D DEMOLI SH
<br />
<br />PROPOSED USE: OSGL FAMILY DWELLING. DMULTI-rAMILY
<br />t:J COMMERCIAL 0 INDUSTRIAL
<br />
<br />Oft OF UNITS.
<br />o SWIMMING POOL
<br />
<br />o MOBILE HOME
<br />.iI OTHER
<br />
<br />DESCRIPTION OF WORK
<br />
<br />D RESTAURANT & HEALTHDEPAkTMENT APPROVAL
<br />5h\(\~l,?' Be - Rt)b4l
<br />
<br />BUILDING SIZE
<br />
<br />SQUARE rOOTAGE
<br />
<br />OJ \ DO
<br />
<br />I
<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 />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTIoN.
<br />
<br />o BUILDING
<br />
<br />PEmfITS REQUESTED
<br />$3) l164.. 4~ VALUATION or TOTAL CONSTRUCTION
<br />AMP . SERVICE 0 FL<)RIDA POWER 0
<br />:::....
<br />
<br />,,/
<br />
<br />w. R.~:
<br />
<br />o SPECIALTY
<br />
<br />VALUATION OF MECHANCIAL INSTALLATION
<br />o OTHER
<br />
<br />
<br />."
<br />~~O '
<br />'2')/~- .,'
<br />~
<br />
<br />o ELECTRICAL
<br />o PLUMBING
<br />o MECHANICAL.
<br />o GAS _ROOFING
<br />
<br />$
<br />
<br />TYPE OF CONSTRUCTION: 0 BLOCK
<br />
<br />o FRAME
<br />
<br />o STEE-L
<br />
<br />o OTHER
<br />
<br />FINISHED FLOOR EL~TIONS
<br />
<br />I S PROJECT IN FLOOD ZONE AREAO YES D NO
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<br />BUILDEll
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<br />SIGNATURE
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<br />COMPANY.
<br />STAT~ CERT OR REGIST #
<br />CITY 'PROCESSING #
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<br />******************************************************************
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<br />MBCBUlI:CAL
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<br />COMPANY:
<br />STATE CERT OR REGIST#
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<br />SIGNATURE
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