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<br />APPLICATION FOR PERNIT <br />CITY OF 7.EI'IIYHIIJJ.LS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT (} EA sA,es SU{1' S --i- IZZ/4 <br />ADDRESS 3 TCJ / J 17t..J( Sit W PHONE 013,.. ?3;Z -6/ell( <br />OWNER CEA S/J,e f1L3~j) <br /> <br />JOB LOCATION <br /> <br />LOT SIZE_L- AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D . l~ <br /> <br />/0 -.,z~ ,-- c:< I <br /> <br />603 6 - 00\':\0 - 66.5'0 <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign/Temp. <br /> <br />_Sign <br /> <br />_1'1ov(> <br /> <br />_Demolish <br /> <br />PROPOSED USE: _Single Family <br /> <br />_M/F <br /> <br />_IF of Units <br /> <br />_~I/ H <br /> <br />lRofJA,vc. T~ Other <br />{ N S'l'ff'-<-. <br /> <br />_Commercial <br /> <br />_Indust. <br /> <br />_Swim, Pool <br /> <br />_Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />L-. <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORNS.** <br />ATTACII (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORNS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />Jj <-"3'5' (? CJ <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br />~ECHANICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_IV,R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Instr1l1ntion <br /> <br />_PLUMBING <br /> <br />3(}{) ,o-VGAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ____Block <br /> <br />_Frame _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />il~QR s.RG.llQN <br />Company <br />State Cert. or Rcgist. # <br />City License Registration it <br />*******************************.********** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />ELECTRICIAN <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />PLUMBER <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />*****************************************~ <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />OTHER <br /> <br />vAN -5L!rI>>1 tT2. <br />J2~~ <br /> <br />Company SJ8tJR-8AAJ <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />!&-oJJApJE <br />01(0 '7 S <br />0/075 <br /> <br />Signature <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br /> <br />i"t~ <br /> <br />.\,<.~ ",..' ,.....~A....., '.:, <br /> <br />,-- "":L~" <br /> <br />~ ..- .....~."". '. <br />