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<br />APPLICinOh FOP PEf'l'iIT <br />CITY OF ZE'c'YRHILL3 <br />BUILDING D~rA~THEN~ <br /> <br />APPLICANT <br /> <br />c U #,uI{Jb#"'''' <br /> <br />Co/f/ &'72 () m~;(/ <br />JYIty> .01 7"'-/ <br />I <br /> <br />ADDRESS <br /> <br />~ A- r~ ;t/Al/;> /l b. <br />JYlA.+ 1111<-5, PeA/id Y <br />JOB LOCATION 39177 /fIeA-t:8'V Lv~.t> ~. <br /> <br />PHONE <br /> <br />521-0'p5"'6- <br /> <br />OWNER <br /> <br />LOT SIZE_X <br /> <br />AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLC~K <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.4fr <br /> <br />O/~ 0 - 000f)6.... 0630 <br /> <br />WORK PROPOSED:____New ConstrucLion __Additio"" ____Alteration ____Repair ____Install <br /> ____Sign/Temp. ____Sign _Hove ____Demolish <br />PROPOSED USE: ____Single Family _H/F _# of Units ,____M I H <br /> _Commercial _Indust. _Swira. Pool Other <br /> <br />_Restaurant t Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />,_Sq'""dre Feet,_ <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS QF BU~LDING PLANS & (1) SET ENERGY FORMS.** <br />ATTACH (3) SETS OF BUILDING PLANS & (1; SET ENERGY FORMS.** <br />**COPY OF CONTF~~T REQUIRED. <br /> <br />P-.ERMI TS 1. .r,illIESJEll <br /> <br />_BUILDING <br /> <br />$ <br /> <br />ValuatiLn of !~tal Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />_ _r'~c( "'9 Po\'7er Corp. <br /> <br />_\oJ.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Ve,luation~,f i",echaniu?l Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />____ROOFING <br /> <br />__________SPECIALTy <br /> <br />TYPE OF CONSTRUCTION: ____Block <br /> <br />_Frame . _St<;el <br /> <br />,Other <br /> <br />FINISHED FLOOR ELEVATIONS: .FT. <br /> <br />***********************~.*.0'~**~********* <br /> <br />Signature <br /> <br />CONTRi.CTOJ'. 5E'T'''''J~ <br />Ce.11pr:'1~Y __ _'_'_' <br />Sta": Cen or Rsgist. IF <br />Cit/ Lice" e Registration iF .J') :J~C:- <br />********************~****..***k*~******* <br /> <br />BUILDER <br /> <br />ELECTRICIAN <br /> <br />Company _ .___._. <br />State Cer' or Regist. # <br />City Licen~e Registration # <br />**************k*****."****, ~************* <br /> <br />Signature <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Cemf 'iny __, <br />Stat~ Cer' or Regist. # <br />City Licert~e Registration # <br />*******************.f ~****~~.~***~******** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Comr ~ny __ ._ <br />Stat~ Cert. cr Regist. # <br />City License Reg~s~ration # <br />*****1.'* * **** * ** * * *** ,; ~ * if **. *. i:';: i: ,': * * * * i: * i:,~ i: <br /> <br />OTHER <br /> <br />Signature <br /> <br />COlilp?ny _____,. <br />St&t~ Cert. or Regist. # <br />City Licerd~ Registration # <br /> <br />******************~~,~** ~*************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />