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<br />A?PI:i.,'j'.TIONi YlrIR P;':RiH1.T
<br />CITY OF 2R'Piiff':! ',,1. L.LS
<br />Bi.JJll.DTOOG j[)lH:P~'~'1/iF:.m'
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<br />OWNER'S NAKE \ToiuJ.My hYlJ'I wA,'T.~
<br />OWNER'S ADDRESS jJo, dot f"CS"..-_-H1S" .i>OYJ
<br />JOB ADDRESS
<br />LEGAL DESCRIPTION: WJ'(S).EA6r5 9~ /0 In.oCK_~SrmDIVLSION HOJO;-F,r A'r.)T Add,'r;'<.II,J
<br />~ f' t
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<br />PARCEL I.,D.f /y-;26 -,d-/ E ~/-./.(f2._g /0
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<br />mONE q/~- 7S"'j- I:) 66f
<br />G A, JLZ.!fY-
<br />
<br />WORK PROPOSED: /JSlev CotlStruction _Addition _Alteration _Repair _Install
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<br />_Sign
<br />
<br />__!!love
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<br />_Deaolish
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<br />PROPOSED USE:
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<br />Single Faaily
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<br />/K/F
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<br />...:2.-, of Units
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<br />_KID
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<br />_~rcia1
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<br />_Indust_
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<br />_SwiB. Pool
<br />
<br />Other
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<br />_Res1taurant & i!~a1t:h ,:lepartJAen1: A[)pl. oval
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<br />BUILDING SIZE: ,. b X~_,
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<br />/0 )/0 __S<r'.;an~ Feet,
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<br />Height
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<br />RESIDENTIAL:
<br />COHKERCIAL :
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<br />ATTACH (2) PLOT PI.J\.NS &: (2) S~'~ v":' :!lJJILDIINfG PI,OS ~~ (1) SEf ENERGY FORMS. u
<br />ATTACff (3) SETS \;,F RUI.Ul!.NG Pi.bi;~.:ir (1) SET RItfflR..;Y }i11ltliS.~-.l\-
<br />**COPY OF COINJTBACl' RlrQmIlJID"
<br />
<br />.r..~~'r,;~_~J1JJEST$Tr,
<br />
<br />_BUILDING
<br />
<br />:$
<br />
<br />.V::JIlil.,.} .!.:m,\'C'f "If~'t:al Con.s!:nlCtion
<br />
<br />_ELECTRICAL
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<br />AKP Service
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<br />,,____...~"I,H:-ida Power C'-':,:p,
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<br />W.~.E.C.
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<br />_KECllMUCAL
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<br />$
<br />
<br />Va1w,d:iOI: ,c,f Mechanical Installatioll
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<br />_PLUKBTNG
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<br />_._GAS
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<br />____RC' .)'[r'ITHlC
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<br />___ ._____SPECI~.TY
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<br />TYPE OF CONSTRUCTION: _Block
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<br />_Fr3lli!e _Steel
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<br />Ot...her
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<br />FINISmID FLOOR F.:LEVATIOINfS:
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<br />,.~ ""fl
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<br />-:.::rj
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<br />i'!h'~:CT Ir~ VLOOD Zm~E AR!"/'?
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<br />YES NO
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<br />*********j ~************~**+'~~~*******-.l\-****
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<br />CO~!Jtl\C1L~Rf..F.C1:JOIN'
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<br />BUILDER~' i c.oofP:~K.T! /1,);rD/Y COII/OT.,
<br />~-/lu '/ Sl:ate Cert:. or Regist:. , ~t1 OC?J.D CJIG
<br />Signature ' _ ,~A _ City I.:ic'CT.i.se ..{egist'i"3tiofi 1# 7d.
<br />. ***itt,e, jUt*"''''. ,......'It***-4\: .fritill:i,'.!...".:e:*x:i;::f::f:il:itil-it**itil:frit
<br />
<br />ELECTRICIAN aJMPM['Cj~~f!I~..:-
<br />Sta1:e 'ecL. ,'lr Rcgist. :/#
<br />Siim:<iture Cl.t:y i, Ceil.lS'~ R.~gip~r:":tion I I r9
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<br />**~*~-ft>.ildh.' ih,,:ir:i;::i;:****itit:'bHl:" >.:* JI::t-* ,
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<br />PLDKBER " 001iPdoi!'~q___ --.!:t:Jdp AI _ ~ A/6r
<br />St:at'e:CC""~, pr Regis!:. #/: F cJo 37000
<br />~ -
<br />Signature Cit:y 1." ~ K~gistr2t:ion.' -- . ....$ '7
<br />-4xitititit**ir*""**.,,,.Il:***,",.. '.He ,.. :..,,"" l:-i\-*'i\-'.' "",':!!::f:*
<br />
<br />MEClJANICALA" . ~.tht ~~ A/ /Vcr'S
<br />~ d ,,;it~t:l:: i~~~:~:::'~-'~Regist:. f fl jrJ, (!)D J8
<br />Signature - - _ __ __ _ ~ . _ ____'-'-' _ L . ,'. . egistration # ~
<br />,~-!L.'~it~-5:ofX:i:~~ 1.;., '''~~c....'~,'J.~*:* .:'. '.: ""..~",,<r..:~ ',:''fi''~ ......: :!:.~~*':!:*~~~'*%
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<br />t.&/
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<br />OTHER.
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<br />. ";~fP~j
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<br />**1l:1t,,:it-f:'.'H<.~' ~'il'1i>:',:::: ~
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<br />~: ~a .:- :'~ -::..:.z l.. _ C:i[ .:: egis~:. ',:'i__,_
<br />.. ity J.:::;.....":1-::ie Regist:rat:iOIl! I
<br />,.. .!-:i<' .-;; :l:**:lII:"'~**.'"'*'-""'''''':lII:***
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<br />Signature
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<br />APPLICATION APPROVED BY
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<br />PERKIT OFFICER.
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