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<br />APPLICATION FOR PERMIT <br />CITY OF ZBPRYRBILLS <br />BUILDING DEPAR'l'MBNT <br /> <br />DATE RECBIVBD <br />PLANS RBVIBW FEE <br /> <br />OWNER'S NAME (~h~ h.. N-~ <br />JOB ADDRESSS" OD3f!.OS+. <br />LEGAL DESCRIPTION: LOT (S) J / BLOCK d. (.0 <br />PARCEL ID # /l)OID/IP?JOOt0D4D <br /> <br />PHONE(B/~)1f3 ~ Oq&t-} <br /> <br />SUBDIVISION <br /> <br />~N FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: []NEW CONSTRUCTION [] ADDITION []ALTERATION [] REPAIR o INSTALL <br /> ~GN [] MOVE )<(. DJl:MOLI SH <br />PROPOSED USE: SGL FAMILY DWELLING []MULTI - FAMI L Y []# OF UNITS [] MOBILE HOME <br /> [] COMMERCIAL o INDUSTRIAL o SWIMMING POOL [] OTHER <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK[)C. (Y)Q..c~/C-LC/t-l. sf'D <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <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 />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[] ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[] FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />[] PLUMBING <br />[] MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[] GAS <br /> <br />[] ROOFING <br /> <br />[] SPECIALTY <br /> <br />,[] 7R <br />~RAME <br /> <br />[] STEEL <br /> <br />[] OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 B!-OCK <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES <br /> <br />o NO <br /> <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />****************************************************************** <br /> <br />BLECTRICIAN <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />I <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />** * ********,*** * ****** ****** ** ********** * ** ** ** **** ***** ** * * * * ***** <br /> <br />MJ:CHANICAL <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />~~C.6!&F <br /> <br />COMPANY CtDSS r;;Vi(~01 ~. <br />STATE CERT OR REGIST # C('7 QC(o 2- qg j <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />