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<br />APPLICATl.OII I'OR PERllIT <br />CI1Y OF Zl!;mIKHII.Lc; <br />BUII.DIIIG DEPARnmKr <br /> <br />0WlIER · S RAIlE <br /> <br />PllDIIE <br /> <br />0WlIER' S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPl'IOII: wr(S) <br /> <br />~SOBDIYlSIOB <br /> <br />PARCEL I..D.f <br /> <br />'.... <br /> <br />1IJORI{ PROPOSED:_lIev Coosuuction -.J'ddition _Alteration _llepair _Install <br /> <br />_Sign <br /> <br />_lIove <br /> <br />_~1i.sh <br /> <br />PROPOSED USE: <br /> <br />Single FaUly <br /> <br />_II/F <br /> <br />_' of Units <br /> <br />_II/D <br /> <br />_ec-erci.a1 <br /> <br />_Indust. <br /> <br />_Swia. P001 <br /> <br />Ot:her <br /> <br />RiPSt:aarant 5: Bea1t:h Departaent Approva1 <br /> <br />BUILDIIIG SIZE: <br /> <br />x <br /> <br />~ Feet, <br /> <br />Height <br /> <br />.RESIDENTIAL: <br />aJlmERCIAL : <br /> <br />A'lTAaI (2) PI.OI' PLAIIS 5: (2) SEIS OF BUII.DIIIG PLAIIS 5: (1) SEI' EllERGY FOlUIS... <br />ATrAaI (3) SEIS OF BUII.DIlIG PLAIIS 5: (1) SEI' EIIEKGY FOKIIS...... <br />..00PJ" OF OOIIT.RAcr .RIlQUIRED. <br /> <br />PII:KJIRTS RlrOlJR.c;nm <br /> <br />.-JUILDIRG <br /> <br />$ <br /> <br />Ya1uation of Tota1 Coosuuction <br /> <br />RI.RCl'RICAL <br /> <br />AIIP Service <br /> <br />F10ricla Power Corp. <br /> <br />V.R.E.C. <br /> <br />---1fECIL\IUCAL <br /> <br />$ <br /> <br />Va1uation of 1f.echani.ca1. Inst:allation <br /> <br />_PUllBIBG GAS ROOFDIG <br /> <br />SPECIALTY <br /> <br />TYPE OF mRSTRUCl'IOB: .-J1oclt _~ _Stee1 <br /> <br />Ot:her <br /> <br />FDlISBED FLOOR ELEVATIOIIS: <br /> <br />Fr. <br /> <br />IS PROJECI' III FLOOD ZOIIE AREA! <br /> <br />YES IiO <br /> <br />......................................................... <br /> <br />alllBACIOR SECl'IOR <br /> <br />RmT.DU <br /> <br />aJIIPAIIY <br />State Cert. or Regist. , <br />City License Registration , <br />......................................................... <br /> <br />alllPMY Fi~~f CI tcC;6 E!ecf- <br />State eet-t. or Regist. , <br />City License Registration' L"--7 <br />........................................... <br /> <br />Signature <br /> <br /> <br />PT.DIRRR <br /> <br />aJIIPAIIY <br />State Cert. or Regist. f <br />City License Registration , <br />......................................................... <br /> <br />Signature <br /> <br />IlEalAllICAL <br />Signature O~ ~ <br /> <br />Cf) NCl~r <br /> <br />aJIIPMY <br />State Cert. or Regist. , <br />City License Registration , <br />............................................................... <br /> <br />I;L:L <br /> <br />OTRRR aJIIPAIIY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />......................................................... <br /> <br />APPLICATIOB APPROVED BY PERIIIT OFFICER. <br />