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<br />APPLICATI05 FOR ~T <br />CITY OF ZEPlrnUiU...:rS <br />BUII.DIliG DEPARniElfi <br /> <br />fitplJ <br /> <br />~;- A- <br /> <br />OWNER' S ~ul ~ 1/ ;J fa/ /h /J~ ft/ <br />_'S ADDllI!SS P. 0. 15 Q}.. 5 /(.. 2- C;f~-j?~rf;j!> <br />3 7 '13 D Of4/L 111 }~~J- JJe. <br /> <br />LEGAl. DESCRIPTImI: UJI'(S) /10 BI.OCK__SUBDIVISI05 l~ (- d t (-- i.~~h) J J <br />PARCEL I.D.I~' 10- ZiP -- L 1- CJ/ 2-0 f'- GO 0 QQ - I/O I} <br /> <br />PHOSE <br /> <br />7j~.; <br />I:;; /IJ. <br /> <br />(., J-S-j <br /> <br />JOB ADDRESS <br /> <br />WRK PROPOSED:~ew Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />-.i'1-"ve <br /> <br />__Deao1ish <br /> <br />PROPOSED USE: ~ingle Faai1y <br /> <br />_K/P' <br /> <br />_, of Units <br /> <br />_K/H <br /> <br />_~rcia1 <br /> <br />_Indust. <br /> <br />_Swia. Poo1 <br /> <br />Ot:her <br /> <br />_Rest:aurant &: Hea1t:h Departaent Approva1 <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDERTIAL : <br />COttHERCIAL : <br /> <br />AT'l'ACH (2) PLOT l'I..iUilS &: (2) SEI'S OF BUIIJ)ING PI.A5S &: (1) SET ENERGY FORMS. f:f: <br />ATtACH (3) SEIS OF BUILDn1G PLUS &: (1) SET EltmRGY FORMS. *-.f: <br />f:f:COPT OF CONTRACT REQUfRIID. <br /> <br />PERl!lITS RP~'9ESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Va1uat:1O> ,".r: 1'0t:a1 Construction <br /> <br />_ELEC"I'RICAL <br /> <br />._AMP Service <br /> <br />ft':l."y..:ida Power Carp. <br /> <br />~E.C. <br /> <br />_MECHANICAL <br /> <br />s <br /> <br />J'a1uaL~,.!;- ..:.f iifecbanica.i Inst:allation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />..:~;OCr'TIiG <br /> <br />SPECI.ALTY <br /> <br />TYPE OF CONSTRUCTION: _B10ck _Fra8€ <br /> <br />. ~Stee1 <br /> <br />Ot:her <br /> <br />FIKISHED FLOOR ELEVATIONS: <br /> <br />Fr. <br /> <br />IS PRO.JECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />f:f:f:f:f:f:******f:f:*f:f:f:f:f:f:f:f:xf:f:f:f:f:*f:f:f:f:*f:f:f:f:*f:* <br /> <br />COWITRACIOR SEC"f'ION <br /> <br />Signature <br /> <br />CO!tPtU(:'! ..... <br />LJ C~ State Cert. or Regist. <br />. , City License Registration <br />f:f:*f:f:*f:f:*f:f:f:f:~f:~~**f:f:***f:f:**f:f:*f:f:*f:f:f:*f:f:f:* <br />/~-r <br /> <br />CO!fi'ANY };.. y"? ~ l-r(.o~{) L _'j' A--<:.. , -, ,. <br />:/. " State Cert. or Regist. #* (.I? 0 / :2. / t.t I <br />. v.,.<.. ~.-I-. Ci1:'..:' License Registr2t:i .eon I ;;2... 0 k:, . -p' <br />"-;:rr;:*"-~'--""u"''''''C "- "- t I~_ _~ U/l<, <br />~ (DfP.OY ~/ t p':S .(l3,4llf. ~~ ==#t I() r; ~ <br />S,t:ate Cert. or Regist: _ f: . "/.. /... ' <br />City X..icense Registration . -r57 l.:z~- <br />f:f:f:f:f:*~:~~~f:f:*f:f:*f:f:f:f:f:******f:f:*f:*****f:*f:*f: <br /> <br /> <br />BIJTI.DER <br /> <br /> <br />S. <br /> <br />PIJJttBER <br /> <br />Signature <br /> <br />Signature <br /> <br />q--c~. <br />~ <br /> <br />../ /' I ~ <br />, / CO!IPi'2I7 P\ i IIJ :5.-'l../ L<O>v ~ _/ ,,~ <br />1/ .----? St:at\n Cf"-=~. oj(' Re,:fst:. # 00 S-'7/ <br />1:. ~:::: > City License Registration # ? / <br />.*f:f:f:f:*~***~f:*f:f:f:*f:f:f:*'_~**f:*f:f:f:***f:**f:f:f:f:* <br /> <br />,:;) <br /> <br />KECllARICAL <br /> <br />Signature <br /> <br />aJIfP,.'''flt____.. . <br />:St:a.t.e (''''''Jf-:-L or Regist:. t <br />_ __ City l..iceJL.e Registration , <br />f:f:f:f:f:*f:*****f:f:*~~**f:f:*f:*f:****f:f:f:f:f:**f:**.f:* <br /> <br />. <br /> <br />OIlIER <br /> <br />APPLICATION APPROVED <br /> <br />BY II ,t tll.!~__ s2j ~T <br /> <br />PERKIT OFFICER. <br />