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<br />Al'PL1:CATION FOR PEmi'IT <br />(;,(n' OF ZJ!J?In"lUll'LLS <br />nUflLDU<; DIlrARlltll!Nr <br /> <br />. , <br /> <br />.' O"-"NE1P S NAME )...,q N G~ <br /> <br /> <br />OWNER'S ADDRESS 2::t o..s-.. <br /> <br /> <br />Jon ADDBRSS 7 ;).. 0 ~ <br /> <br /> <br />LEGAL DESCRIPit'ION: toTes) <br /> <br />PAACEt I.D'.# <br /> <br />sp ~~fL 11"\.;'0 <br />19 S;.I J.J7 /'V (J <br />A- s H .Aft I"- 0 <br /> <br />Jmo~m >r/,?- 7~8- <br />O&-.!-___~~ <br />jJ_1S... <br /> <br />~9o~ <br /> <br />----.-n~sunDlnsIOL f1 J..... pH f}--/IS.iL~ <br /> <br />k~RK PROPOSED:____New Construction ~ddition <br /> <br />~tcr3tion <br /> <br />----Repair ____Install <br />I <br /> <br />_Sicn <br /> <br />_Hove <br /> <br />_D C.ltO 1 ish <br /> <br />PROPOSED Y~E: *,Sinele Fa.ily' <br /> <br />_--..lf/F _' of Units , <br /> <br />---11/8 <br /> <br />, _eo..cX"cbl <br /> <br />---.J,n.dust. _Swia. Pool ' , <br /> <br />Other <br /> <br />Restauran.t & Ile.alth DCp.3:('~nt i\pproval <br /> <br />BUILDING SIZE: ----^--_. <br /> <br />Square Feet, <br /> <br />Heigbt <br /> <br />RESIDENTIAL-: <br />COHHlmC'l.AL : <br /> <br />AT1"^CJI (2) PLOT PIA~S & (2) SKIS OF BUllDIHG P~S & (1) SET ENeRGY FORMS."* <br />A'l"rACU (3) SE1'S OF nUIl.DX~G PLANS & (1) SEX' F..NERGY FORtIS... <br />.*CON OF CONTkAct lUrQUUWD. <br /> <br />))f!mt:ITS ~~QI[F~5'rJm <br /> <br />~UILDING <br />--.ELECTRICAL <br />~CUANICAL <br /> <br />$ <br /> <br />Valuation of Tou1 Constrvction <br /> <br />Nil' Service <br />$ #/ gso OV <br /> <br />_----"lo;dda POW'Cr Corp. <br /> <br />Il.R.E.C. <br /> <br />Va1U3tion of Hech.:mical Installation <br /> <br />----"pLUMBING CAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block. ---..Fr~ _Steel <br /> <br />.Othet' <br /> <br />FINlSlIED PU>OR ELtVAnonDS: <br /> <br />IT. <br /> <br />IS P.RO.JECT IN FLOOD ZONE AREA? ' <br />, YES <br /> <br />~~.~t~t..t._.~*....*.*....*..........~.... <br /> <br />NO <br /> <br />a)~rRAcroR ~H~ <br /> <br />BUILDER <br /> <br />ruff <br /> <br />OOHPANY <br />State Cert. or Recist. f. <br />City l,icense Registl"3tion . "- <br />.~*.*..*.*..*..~..*...............*..t.... <br /> <br />Si,en.atuX"e <br /> <br />ELECTRICIAl( <br /> <br />)VA- <br /> <br />, <br /> <br />a>>J.11ANY <br />Stat.e Cart. or Regist. , <br />, City License Registration , <br />t~.*44..A<<sA.A*O.............tt.t~.~t.~t.* <br /> <br />SiP.n3tu~e <br /> <br />PLUKnER <br /> <br />(VA <br /> <br />COttPANY <br />St."ltc Ccrt. oX" Rcc:ist. i <br />City License Rceistration , T <br />***.A***....A..**...t.t...t..t.tt*.t~~ttt* <br /> <br />Si&n3ture . <br />". <br /> <br />l1ECUt\NI CAJ. <br />SienaturcL,,-_fJ<.~~ <br /> <br />~ Cl>>Il'Al<Y~O UIH 1Z:1Lh. CD,.... f-o..... T 61Jl <br />Stat~ Cc:rt. or Regist. # - RmOtJI.,,-D 2-L: <br />. City License Reeistration , , J-.7 <br />.**4*tt*.A*...........*~****.....*.*...... <br /> <br />~ <br /> <br />jJ) Et: 001tP~ <br />. ' State ~rt. or Reeist. . <br />I Ci~ License Reci$tr~tion , <br />.....*............................*....... <br /> <br />Sign4turo <br /> <br />APPLlCAnON AI-I),ROVeo BY <br /> <br />PERlIlT OFFICER. <br />