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<br />.. <br /> <br />APPLICATION FOR PERftIT <br />CITY OF ZIl;I"IlI.KIIlLLS <br />BmLDUiG DEPAR'nIEXT <br /> <br />OWER'S NAME lI1e. # d .B GIl +U c4 PHONE 'If73-8I!11 <br />OWKER'S ADDRESS ,,?OLf 00 h,'flWl}1 iJ/l. <br />.JOB ADDRESS La) b5 6bJ.7 r~/J)oCJ~ LJa 2 0p~ ~fl--L>II., <br />I.EGAL DESCRIPJ'ION: Lm(S) lo~ RIncK SUBDIVISION 5; Ju/-(\... O.?YL.. <br />, PARCEL LD.' 0'3 - L fa - LJ - ()) 20 - 00000 - 0.,50 <br /> <br />,",'URK PROPOSED: ~ew Constructi,on ~dition _Alteration _-.Repair _Install <br /> <br />_Sign <br /> <br />_!!love <br /> <br />_De.o1ish <br /> <br />PROPOSED USE: <br /> <br />~g1e Faai1y <br /> <br />_"'F <br /> <br />_' of Units <br /> <br />_H/H <br /> <br />_eo..ercia1 <br /> <br />_Indust. <br /> <br />_SwbI. Poo1 <br /> <br />Other <br /> <br />_Rest:anrant 5: Hea1t:h J)epart.-.en.t Approva1 . <br /> <br />RUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />~ESIDENTIAL: <br />GOttKERCIAL : <br /> <br />ATTACH (2) PLOI' PLANS 5: (2) SEI'S OF BUILDING PLANS 5: (1) SET RRERGY FORMS. H <br />ATTACH (3) SEI'S OF BUILDDDG PLANS 5: (1) SET ENERGY FORKS. *'" <br />**COPY OF CONTRACT RIlQUTRIlD. <br /> <br />.. <br /> <br />PERlPnTS REQUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />'7'tf"o~ <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Va1uatioo of Tot:a1 Construction <br /> <br />~rida PoweT Corp. <br /> <br />W.R.Y..C. <br /> <br />_ftEC8AlUCAL <br /> <br />s <br /> <br />Va1uatioo of Hechanica1 Installation <br /> <br />_PLUPtBIlfG <br /> <br />GAS <br /> <br />ROOFDIG <br /> <br />~aak <br /> <br />,. <br />SPECIALTY <br /> <br />TYPE OF CONSTRUC'l'IONl: <br /> <br />_B1ock <br /> <br />_Stee1 <br /> <br />Other <br /> <br />fTIlfISJIED FLOOR ELEVAnOINS: <br /> <br />PT. <br /> <br />IS PRO..JECT IN FlOOD ZONE ARP.J\? <br /> <br />-" <br /> <br />YES NO <br /> <br />************..****..********************** <br /> <br /> <br />CDllI'I'RAcroR. SECTION <br /> <br />~ OOMPANY uJ.C ~~~ cJ /!~_. <br />Q St:ate Cert. or Regist.' ooZOt Z-.'1 <br />.'_~"'-- City License Registration , Co/ <br /> <br />::J..**.......****=~*J5;;;;:r~~:tk~ ~ <br /> <br />St....ate Gert:. or Regist:. , ("Pv~" '-I t s-- <br />City License Registration I I tJ <br />********************************** ******* ~ , <br /> <br />~.L. <br /> <br />PLOfBER <br /> <br />CO!fPANY <br />/?~ _... /? St:ate Gert. or Regist,. f: <br />~ ,-,..~ City License Registration I <br />****************************************** <br /> <br /> <br />Signature <br /> <br />KJN~~; e~ilJ <br />St:ate Cert~ or Re~t. , G<!) ".)'/ / p.., <br />City License Registration' 7/ <br />,~ / ~ ****************************************** ' <br /> <br />9T1IRR G ~ OOPIPARY tJ/!//J h/J~;~? <br />./ ~ /l St:ate Gert. or Regist. , Lc ~t'9"6-t ~ <br />Sigflature -/'i.--'" L....--.. City License Registration' '3 0. <br />****************************************** <br /> <br /> <br />coPIPAIIY <br /> <br />,.\PPLICATION APPRuvtfD BY <br /> <br />PERKIT OFFICER. <br /> <br />...,.:. <br />