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<br />eln . OF' 91'BYlUIII.I.S nma~ U1'LIeHION <br />JlUII.D~a IlUU'fWKH'l' 15335 I- It, J~ll., n. 33I1U <br />113-710-0020 r.lXII13-7'0-0021 <br /> <br />'( rf \ ~~ "j \ \ <br /> <br />. '1IIo&, <br /> <br />>>Aft UC21WP <br />. I1BOHa ~AC1' IQ\ ~ImMO '113,-'j~(P....c19~.s- <br /> <br />. I <br />N\ r.'. SS; . 1 . /YJCYlI I CIf <br />OWEl'S NAMi II \ f:\r<'{ .:> A . . Am AN PHONE @,3 -'7g2..-~'f.s-7 WCt:tsUN <br />ox. ADDU'" 725/ AfP~~/J--C; [)I!.. 7:./-'.,'11$. FL' 3J~ <br />LEGAL DESCJUPTIONI LOT(S) 't:)' .LOCK 'SDBDIVISIOH A lPh~ 'U; Ll "ti.e. G:STIlTes <br />PAaCEL ID t .J~- 2.~?.(-()(J5'o-~tJlJlJ -c 100 Inll!'ll.IV I'Rnw PRnPr.II.'l'Y ",ax NMTI'!r.\ <br /> <br />WORX noPSED, dMEW cotIlT1\.UC1'ION <br />aSIaN <br /> <br />a ADDI'l'Ioel <br />b WOVl <br /> <br />a~'rERA'1'ION <br /> <br />C gPAIR <br /> <br />a DlS'rIW.. <br /> <br />PROPOSED on: aSGL rNolILY OWELLINO <br />aCOHHEItCIAL <br /> <br />aWULTIwrNolILY <br />. a niDUSTllI~ <br /> <br />a D2WOLISB '{2ep14~~~ T <br />0, or OHI'J'S a tf:>BIJJ: RONI <br />o S~IMMIWG POOL a OTHER <br /> <br />" <br /> <br />oa.c:auflOlJ or NeaK <br /> <br />c:J RE81'ADlWrr , IIWTH 9i'AR'l'NEN'1' APPROVAL <br />t2ePlACa- 1 c10()J'€. s; -z.e-./ SI'.~ <br /> <br />BDILDING SIZE <br /> <br />SQOUK J'OO'l'AGI <br /> <br />RElell'1' <br /> <br />USIDDlTIALI ATTACH (2) PLOT',%.A)l', (2' .ui or BOXLDIllCl,wI' (1) AT .wzaGY POlHS. <br />COttiUCIAL: ATTACH (3) SETS or 'BOILDING 'WI' (1' BU EilEMY fORMS. <br />IF Slaw PERMIT OWLY 12) S~TS or EHGI~EEltD .WS'REQUlaID. <br />PROPERTY SURVEY alQ01aED roa ALL NEW OOWSTR~ION. <br /> <br />, <br /> <br />- <br /> <br /> <br />PZmaTS RJl:QUESTKD <br /> <br />,/.< <br /> <br />o aoILDING <br />a ELr.cTlllCAL <br />o PLOfBING <br />a NEOWIlCAL <br />o GAS 0 ROOFING <br /> <br />.' <br />/ <br />,/ <br /> <br />o SPECIALrT <br /> <br />VAI.DAUON or toUL COH8'f1lDC'J'ION / <br />... ...,,;;,. 0 "'...... ....... 0 (....0. <br /> <br />~OATION OF ~lIANCI~ INSTALlA'l'I\ <br />OOT~Il' , <br />'"', <br />" <br /> <br />~ <br /> <br />VA-I \A-€, <br />jot) 7. <t? <br /> <br />, <br /> <br />TYPE or CONSTJI.OCTI00 I 0 BLOCK <br />rINISilD FLOOR ELEVATIONS <br /> <br />o nwo: <br /> <br />a STalL <br /> <br />'OOTllER <br /> <br />..'........,......t. <br /> <br />II. PROJEC'l III FLOOD ZONJ: MEAO YES <br /> <br />a )10 (" <br />?6eP.. A~oN"1 CA+ P>.fI;l:J .nr <br /> <br /> <br />8IlnI.DD <br /> <br /><,"J <br /> <br />b~(~ <br /> <br />~CL\)l <br /> <br />CONPANY <br />, <br /> <br />SIGNATURE <br /> <br />STATI CERT OR UGlST t <br /> <br />..................**............*..**............................. <br /> <br />n.tMIU <br /> <br />'ICDO.TUU <br /> <br />CONPANY' <br />STATZ CERT OR gGln f <br /> <br />, . <br />..........................................*.**.................... <br /> <br />~CAl. <br /> <br />COWPlUlY . <br /> <br />SICMATOIU: <br /> <br />STArE CilRT 0& lEGln . <br /> <br />.- <br /> <br />.**.**........*..~......................*....~.~.....*........... <br /> <br />cmID. <br /> <br />C<>>IPANV <br /> <br />r, <br /> <br />S I GX7.1'01\.! <br /> <br />8TATZ CE&T o~ kEGIST . <br />