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<br />APPLTi.:ATIOWl FOR PERMIT
<br />CITY OF ZEPIfY'K"IT.,.I,;:i
<br />BUII.DllIG DEPAK.ntmiI'
<br />
<br />PARCEL I. D. f
<br />
<br />uJ.4-;Jr:VN'\.4Vr/
<br />f! 0 . /SJ~ s r ~ ~(fl.f-y~'/Is
<br />3 7 Lj 23 LD (- ~ ~ 1-- w J J ~ 1) ll.. ,
<br />77
<br />/cJ-2"-'2-/
<br />
<br />_PHONE
<br />
<br />78 g- - (. .r j -7
<br />~I.
<br />j- j.,
<br />
<br />OWNER' S MAKE
<br />
<br />OWNER' S ADDRESS
<br />
<br />JOB ADDRESS
<br />
<br />LEGAL DESCRIPTION: I.OT(S)
<br />
<br />SUBDIVISIOOO ,AJ ~ J f t- '"<I .'1< J J
<br />.JlLZ U - CJuo,hJ ~ d ,/'0
<br />
<br />BLOCK
<br />
<br />KORK PROPOSED: ~ Construction _ __Addition __Alteration _Repair _Install
<br />
<br />_Sign
<br />
<br />_.__lItove
<br />
<br />__DetIolish
<br />
<br />PROPOSED USE:
<br />
<br />~e
<br />
<br />Faaily
<br />
<br />_KIF
<br />
<br />_' of 1JJnits
<br />
<br />_K/H
<br />
<br />"_~rcia1
<br />
<br />_IOOust.
<br />
<br />_Stn.. Pool
<br />
<br />Other
<br />
<br />_Rest:aurant &: Health nepan:.ent Approval
<br />
<br />BUILDING SIZE:
<br />
<br />x
<br />
<br />Square Feet.
<br />
<br />Height
<br />
<br />RESIDElwTIAL :
<br />rottttERCIAI. :
<br />
<br />A1TACII (2) PI.OT PLANlS &: (2) SEIS OF BUILDDiG PLUlS &: (1) SEI' ENERGY FORMS. "''''
<br />ATTACH (3) SEI'S OF BUII.DllJG RUS &: (1) SEI' mmRGYFoRMS.....*
<br />*.CO:PY OF CON'l'RACl" REQ(JJI]mD,
<br />
<br />.p~mfS ~0ES"fJ"J.!
<br />
<br />_BUILDING
<br />
<br />$
<br />
<br />Va1uation of Tot:al Construction
<br />
<br />_ELECTRICAL
<br />
<br />AKP Service
<br />
<br />_FlcTiea Power Corp.
<br />
<br />i/'il.R.E.C.
<br />
<br />_ItECIIANICAL
<br />
<br />$
<br />
<br />_Val1!J3tf':>i~.!f Hecbanica1 In.c;....allat:ion
<br />
<br />__PJ,JJKBTSG
<br />
<br />GAS
<br />
<br />. JbJOY'D ~'
<br />
<br />SPtiCIALl'Y
<br />
<br />TYPE OF COliSTRUCTIOINl: _Block __F.::.dU?'. _ _SceE:I
<br />
<br />Other
<br />
<br />FDiISHED FLOOR ELEVATIOUS:_
<br />
<br />FT'.
<br />
<br />IS PRo.JECT Di FLOOD ZONE AREA?
<br />
<br />YES NO
<br />
<br />,",Jl"*****~"'***""*.*""*""***"'*"""""".""...""*""""*..*.
<br />
<br />aJINl'I'RACI\lR ._SECTION
<br />
<br />BUILDER 4 OOlfP.....c .A>. A_;Jf:..)'lI\ 4"/./ (;.Hj..) iA-L
<br />II} j). St:at:e Cert. or Regist. ,"---ADO:z.. 0 ~1._1,.
<br />Signature ~~~ J:"ity License Registration'
<br />. ..........***...............*,11:.',,,>11:....*.....,.:-...*"'........................................
<br />/--; . . .. /-
<br />ELECTRICIAN "",,/ . (+''> '. ^/, 1!.;r)Mp.i\'L!V.~...!!.._~'-f/'._u"'-@~-,/{ /../..--,\_./0.-
<br />(' -,... Cd" - (- -<_J-tJ.()--A'- .- "..... R - <10. /'< (' I /J I, J /
<br />. ;..\'-:-/ p" (l, /'V ..a:ate ,-,,<::1:1:. iQ eg....:,:t:. .". c..' ~""\ I~
<br />S. t:ure' <: . VI- I'lL- ;-"., I ". L,. City Licer.lSe Reg." sl~t:iou t ~ (l (", ~ /
<br />...**......"'''''i:-**......,J:......................a-....*.............*. . ctJ.* t~ ...e.r r ~ h, ~
<br />
<br />. jt~ OOJIPARY '
<br />
<br />State Cert:. or Regist, j: . f F~ f5 _
<br />City License Registration I __ / ~~
<br />...........*....*"'........*...........*.*...........~*...........................*........*......
<br />
<br />PLUttBER
<br />
<br />
<br />
<br />Signat:ure
<br />
<br />Signat:ure
<br />
<br />
<br />ClJl!WLU"'l.7_ ~'; (V 51Z,/
<br />State GeT..... or Regist. I
<br />Cit..-y Lic.e:..se Regist:ration
<br />.........."''''....* J:*.....*.*.....*,~i:....*................'<<*....**............*......
<br />
<br />C ,9. ' fr.~7
<br />Ch) '.:,-~//J2..
<br />I z-:' '7/
<br />f..... -",. f
<br />
<br />, <:/
<br />/ .
<br />
<br />MECHANICAL
<br />
<br />aJK?,.)fi'
<br />St:at-:' {"~ to or Regist:. I
<br />Cil:"j'".::" :e:D:5e Regist:rati~ I
<br />.........."'.,..;il'*......b..:....','l-.**..~.",~*";. ...,:.s.... ~'i!.*..............iI:......*
<br />
<br />011IER
<br />
<br />S ignat:ure
<br />
<br />APPLICATION APPIlOVED n <-j( CJ.-MAA~>$~ ~A AfYlJ
<br />
<br />PERMIT OFFICER.
<br />
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