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<br />APPLICATION FOR PERMIT <br />CITY OF ZBPHYRRILLS <br />. BUILDING DEPARTMENT <br /> <br />DATi: lUI:cEIVBD ~/il() ~ <br />PLANS RBVtD Jm& <br /> <br />owNER'S IIAHE ~ I a. '( <; we Wl\d1 {( I ~ ' PHONE1'ill', "fr. ;,<;7 <br />JOB ADDRESS & 51 \ 'J ;C.\o R i CW'\ W~ <br />LEGAL DESCRIPTION: LOT(S) ~;:r- ~~LOC~__ _~UBDIVISIONC;;\vtfah W~Jl.,t <br />PARCEL ID # ______~~ ~~)(J/) ~~ (OBTAtU FROM PROPERTY TAx NOTICE\ <br />WORK PROPSED: ONEW CONSTRUCTION 0 ADDITION OAL;ERATIO!l 0 REPAIR t1 iNSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI - FAMI L Y <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMIN'G POOL <br /> <br />d MOBILE HOME <br />o OTHER <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK \\JeoJ' 1-~M~- r~"(i.~ t',\j}~\- 0" .Q Ie (\J/~ <br />BUILDING SIZE ~/ 'f 5?1 it" SQUARE FOOTAGE ~ Lt6t1 HEIGHT <br /> <br />RESIDENTIAL: <br />CO~ERCIAL: <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FoRMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />~~11 <br /> <br />r;t BUILDING <br />~ECTRICAL <br />~UMBING <br />CV;;ECHANI CAt <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br />~E <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />~ <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br /> <br />SIGNATURE <br /> <br /> <br />~ <br /> <br />COMPANy-----1!:ll Ii ~ ~. PiJ.4;{l~ <br />STATE CERT OR REGIST 1/ <br />CITY PROCESSING # 7+t~~ <br /> <br />BUILDD <br /> <br />BLBC'l'RI <br /> <br />************************************************************* <br /> <br />?i~_.F Ck~5 8ech~c- <br />COMPANY '..f( <br />STATE CERT OR REGIST it ~rc CX:.bJ;2)?cJ <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />*************************************************** <br /> <br />COMPANY 04/>, ~~J ff~ <br />STATE CERT OR EGI # (! . - &-5/3- <br />CITY PROCESSING # I~~ <br /> <br />PLUHBBR <br /> <br />SIGNATURE <br /> <br />*******************************~*********#~***** <br />COMPANY ~o A/~ ~ <br />STATE CERT OR REGI ST # rR fY\ f) 0 I <r tt Cr ( <br />CITY PROCESSING # <br /> <br />ao:CBARICAL <br /> <br />***************************************************************** <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />OTHER <br /> <br />***************************************************************** <br />