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<br />CITY 0' ZBPBYBBlLLS <br />BUILDING DEPAR'l'tIIRT <br /> <br />'vV\~d-~ <br />.; ..e.162hy~~ <br />, <br />BLOCL-SUBDlVISIOtl <br /> <br />PHONE <br /> <br />78' :J.. - .1(1 q b <br /> <br />OWNER'S HNII <br /> <br />~jf\A ~ <RAJ/ 1 <br /> <br />OWIIEI.' S ADPUSS <br />JOB ADDUSS t., l) L{i..J ()1'l st <br /> <br />LEaAL DISCIllPTI01l: LOT(S) <br /> <br />8, ,~3S4{) <br /> <br />PARCEL I. D.' (oBTAIII nmr pJlOPD.'l'Y TAX HaTlCR) <br />WOIUt PIOPOSBDa__ew OoutructiOD ---Addition .-JlteratioD bpail: _latall <br /> <br />...-Jian <br /> <br />PROPOSED USI: ~iD&1e ruil.y <br /> <br />..----JIove <br /> <br />~liah <br /> <br />---"'F <br /> <br />_' of units ...-Jt/B <br /> <br />_ec-ercial _lndust. ~wia. Pool _other <br /> <br />____otaUr...t. . BN1th Deport:aent Approvol ,., ~^""~ I ~ [f;,. <br /> <br />DESCRIPTIOH OP woRltI~a~ J,f.j 0 Tp tr..lllL J ~,' ~'"l P <br /> <br />BUILDIIIC S1ZBI x '. Square Feet, Beipt ?Ia~ <br /> <br />RBSlDBIITUL: ATTACH (2) PLOT PLANS 5; (2) SEtS OF BUlLDIRG PLANS' (1) SET BlBROY POIMS. <br />cotIKBIlClAL: AnAca (3) SBTS or BUILDING PLUS , (1) Sft DUGY 'OllIS. <br />Pl.OPBk'tY SUltVBY UQUIUD POI. ALL Naw COIISTlWCTION. <br /> <br />PRRMITS RmURSTRD <br /> <br />-BUILDIHG <br /> <br />,rL''Dt:> oV <br />$ ~7a <br /> <br />Valuation of Total construction. <br /> <br />RI..JC'l'RlCAL <br /> <br />AtIP Service <br /> <br />Plod.da Power Gorp. <br /> <br />W.Il.B.C. <br /> <br />~CAL <br />~111G <br /> <br />s <br /> <br />valuation of Hecbenical tutallatiOlL <br /> <br />GAS <br /> <br />ItOOnllG <br /> <br />s'BCULTY <br /> <br />TYPB OF W.SftUC'J'10R: -..Block _'raae -BteeJ. <br /> <br />Other <br /> <br />rDlSBBD FLOOk BLlVA'I'IOIlS = <br /> <br />Fl. <br /> <br />IS PllOJBCr 11 PLOOD ZOBB ADA' <br /> <br />TIS NO <br /> <br />.......................................... <br /> <br />BUILD"" cr - <br />slgoature ~'- A <br /> <br />WflIt:RACTOR SECTlO. <br /> <br />o ~ f <br /> <br />\ State Cert. or Ileaut, . <br />\~ City Liceoae Begistration' <br />..*.....~__..~6~............*........ <br /> <br />COKPARYr--S~d/U~ p::' L::;; S'/A, <br />Il;p~. Sta~e cert. or" .~~ .,.. <br />'4ftV City Liceaae Ileal tratiOQ' Irrr2^1 <br />..... ................................. <br /> <br /> <br />v <br /> <br />n..J!.CTlU.CUIt <br />Si--ft ./ A ;' .-c.n~y <br /> <br />~ <br /> <br />PI"IIIRKIl <br /> <br />COttPAJIY <br />State Cert. or Ileai.t. . <br />City Ltceaee Rea18tration . <br />.........*................................ <br /> <br />5isnature <br /> <br />MItCIWIl.CAL <br /> <br />COMPANY <br />State Cert. or Reatst. . <br />City Llceaae a.atetration t <br />.......................................... <br /> <br />Sisnat~re <br /> <br />m:ua <br /> <br />COHPANr <br />State Cert. or Realat. . <br /> <br />...............t.~::;t;fceoae leat.trattoa , <br />................... <br /> <br />Sianature <br /> <br />APPLlCAttOll APPltovBD BY <br /> <br />PDHIr O"Ie.. <br />