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<br /><'I A_ I g-r -loU II l'-\Ct1\~ ~ \ 1l\ \.\ <br />APPLICAnON FOR PERKIT 0 J ,() .. '^ " .~. n <br />() rt I I f~::lJU-^A v :\.^{)Ul. <br />CITY OF ZEPIIYRIIILLS lU""\ <br />BUILDING DEPARTHENT <br /> <br />=:: ~~~i~~ecJ;~\~~c <br /> <br />JOB ADDRESS l64L\tS Gn \ \ b \ \( cd <br /> <br />~ fI3-'72d-SS04? <br />7e .1 ~ IFl ~%41_ <br /> <br />LEGAL DESCRIP'I'ION: LOT(S) BLOCIL--SUBDIVISION <br />PARCEL LD.' 3alo~\a~CXJ()OCbl0 \10 (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew ~truction ~ition --...Alteration ~epair _Install <br /> ~Si~'k.a \ \ C*1{~ ---.JIove _Deaolish <br />PROPOSED USE: _Single Fsaily ---1I/F _' of Units ---1I/H <br /> Vec-ercial _Indust. _Swia. Pool _Other <br /> <br />~estaurant &: Health Departaent Approval <br />DBSCIlIP'fi08 OF WOIlK: \~\\ ~\\.t~ed CI-'Y'J.J')ne.i \e-i\u's <br />BUILDING SIZE: 52.lo1x 2- .J Os.~~~quare Feet.J ~ Height <br /> <br />RESIDERTIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REOUESTED <br /> <br />.',;UlU>JJJG C~I~~~~~~rnmar..-L~~~~ ~ <br />~ELEcnuCAL ,. A!IP Service Flor~power Corp. W.R.E.C. <br />---"ECIIAlIICAL $ Valuation of lIechanical Installation <br /> <br />~UKBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CORSTRUcnON: _Block _Fraae _Steel <br /> <br />Other <br /> <br />PI1IISBED FlOOR ELEVAnORS: <br /> <br />Fr. <br /> <br />IS PROJEcr IN FLOOD ZONE AREA? <br /> <br />I <br />/ <br />! <br />Bml.DRR I <br /> <br />Signaturj <br /> <br /> <br />YES NO ~ <br />.......................................... fl' > <br /> <br />CO~cr~sEcrmN ~ <br />COMPANY SC'.aJ CAl'oL-t-1 rY/ ~~ <br />State Cert. orlRegist~SO(OO~W / <br />City License Registration . 7;;' X" <br />.......................................... <br /> <br />:~ ~ Jr COMPANY <br />, "I ' , <br />/ State Cert. or Regist. , <br />e crv' (I\.,. City License Registration , <br />.................*.....................*** <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />....*..*...*....*.....***.....*..........* <br /> <br />Signature <br /> <br />IlECllARICAL <br /> <br />COIIPANY <br />State Cert. or Regist. . <br />City License Registration f <br />**.*****.**********.**************.*.****. <br /> <br />Signature <br /> <br />OTRRR <br /> <br />~1;'; <br /> <br />COIIPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.........*.~*...***.......*......~.~...*.* <br /> <br />Signature <br /> <br />APPLICATION :APPROVID BY <br /> <br />PERKIT OFFICER. <br />