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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OllIIER'S _ (~rr,/ <br />V <br />OWNER'S ADDRESS <br /> <br />fI~ ~f?/ff~ <br />. <br /> <br />S/2... <br /> <br />PHONE <br /> <br />71(.3 -bO j~ <br /> <br />JOB ADDRESS <br /> <br />3~o ;;L6 <br /> <br />?~ 1'9'1'1/1;) t9 <br />I? BLOCK <br /> <br />?OOfJ r 2</17/?jtl/~ ~/ <br />SUBDIVISION WA'fk/~tJ M,Vf/ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />PARCEL I.D.' (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:~W Construction -..Addition ---Alteration _Repair ~nstall <br /> <br />_Sign <br /> <br />----'love <br /> <br />_DeIIOlish <br /> <br />PROPOSED USE: ~S~leF_ilY <br /> <br />_M/F _' of Units _M/H <br /> <br />_<=<-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />_Restaurant &: Health Departaent Approval <br />DESCRIPTION OF WORK: ):;vJiAl /A--f-tOA/ c;f' /Z#dbrle Nor14J./L. <br />BUILDING SIZE: ~r X s6, Square Feet, Height <br /> <br />RESIDENTIAL: <br />COMKERCIAL : <br /> <br />ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />ATTACH (3) SETS, OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED POR ALL NEW CONSTRUCTION. <br /> <br />~~LDING <br />~LECl'RICAL <br />~GlWlICAL <br />~PLUMB~NG <br /> <br />$ <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />I 700, 0 iJ <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF mRsTRucnoR: _Block _Fraae _Steel <br /> <br />~ <br /> <br />Other <br /> <br />FDJISBED FLOOR ELEVAnONS: <br /> <br />Fr. <br /> <br />IS PROJEct IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />mKPANY ~/1/IJ.IS~ A#o6{!e 1r:k/JHe..r <br />State Cert. or Regist. . CO f:) F-lftr6 <br />City License Registration . <br />.......................................... <br /> <br />RI.RCTIlICIAII . COIIPAIIY ~ -"'-V fljie 8~~~<o 'il:;vc.- <br />-U _ ~ State Cert. or Regist. . 1..('396'5- <br />Simulture ~ City License Registration . ::2 &. (:; <br />. -- - . ... ...................................... <br /> <br />PLUMBER 5dU ~ COIIPAIIY 5:'CAVr? ISe ~r/#c ~ <br />State Cert. or Regist. . 00 criS' <br />Signature City License Registration t <br />.......................................... <br /> <br />IlEGBANlCAL ~ COIIPAIIY ~~P(!i'.e S&e.,>"~4 b <br />OJ . State Gert. or Regist. . ~:3 'hS <br />Signature ~ City License Registration . / Jj t.. <br />~ .. ....................................... ' <br /> <br />BIJII.DER <br /> <br />~~ <br /> <br />Signature <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />............*.....*.....**................ <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />