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<br />APPLlaAtl0N FOR. PBlKIT <br />CITY OF ZErHYRHILLB <br />&utLDING DEPARTMENT <br /> <br />---) <br />0puJL <br />, ISH B- Cf0 <br /> <br />OWNER'S IIAHIC .1~.LJ::1~i<;.~.__.._________PHON.R 119/3_ '7'13 - ~S6' <br />OWIIR'S APOllIStl Po,t3CJ7<. '-/t;J8-t J>!.EZwi?o~T 12'-c..I.H~Y, PI ='3..U....">,.. O'-f~p. <br /> <br />JOI ADDU88 ,3<1 , 'i. I (..,.. J.,. A<JE..., <br /> <br />l),~ ...,> 1 - (" <br /> <br />LB<W. DISOUmOlh LOT(S)_ , <br /> <br />B~5U8DlVISlON <br /> <br />PARCEL I.D.' I:;) :.,x" - a L:_.....__ (OBTAIN PROM PJIOPItRTY TAX IOTJCll <br />WRIt PROPOSllh-LtlftV Coaat.ruetion ---...Addition ~teration __Jtepair _lutall <br /> <br />_8i80 <br /> <br />_.--'lo"e <br /> <br />--.Dgolish <br /> <br />PROPOSED USE: -Lsioale F..Uy <br /> <br />-----,,'F ....L, of Units -----K/8 <br /> <br />__eo..ecclal <br /> <br />_lndust. _Sviti. Pool _Other <br /> <br />~e.taurant , Hcalt~ Depart.ent Approvel <br /> <br />DISCRIPTlOI 0' VORl: <br /> <br />S.E~~ J:h"l~C~ED L.J~ln;:,- JR * PJ..AN.~ <br /> <br />BUILDING SIZE: <br /> <br />...x <br /> <br />~.___.__Square Peet, _ <br /> <br />Height <br /> <br />RBSIDP.RTIA.L: ATTACH (2) PLOT l'lANS &: (2) S8TS OF BUllJ)ING PLANS' (1) SBT BNERGY PORMS. <br />ootIlIERCIAL: ATTAaI (3) SETS OF BUILDING PLANS It (1) SRT BMBRGY FORMS. <br />PROpan SURVEY RBQUlIlBD POR ALL NEW CONSTRUCTION. <br /> <br />ElBtll'f3 Jl,BOURSTG <br /> <br />/B11IwtRO <br />/' KI.EC'l'UCAL <br />.LJmalAW1CAL <br />/pt"~RG <br /> <br />$_ I 8~l~002...:. <<? ~_ _,__Valuation of Total Construction <br /> <br />, {;J, ~ Service <br /> <br />_____'lorida Power COrp. <br /> <br />W.R.B.C. <br /> <br />$..~__V.lu.ation of "~('b8n1c.l Iostallation <br />GAS ~_,~OOPING ___._SPBClALTY <br /> <br />'1'YPB OP OOlISU.ucnOM: -Laloclr. _Frue _Steel <br /> <br />_Other <br /> <br />nlllSBID FLOOR BLBVATIONS =__ <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE ARIA' <br /> <br />YIS <br /> <br />- <br />NO <br /> <br />.......................................... <br /> <br /> <br />CO.TRAWl SECT I 014 <br /> <br />WKl'AKrJ..laf2.L..c. J-! a me.", ~ '~p~ v. R'( LAIt J(;,\ !J!. <br />Statt! Cert. or 'Re81at. '. CJ3 co ."3I~.,,-/q <br />City Lic@fts~ Registration . /93 <br />.......................................... <br /> <br />fL4 COMPANY Ko G--e~s E'--~~TRI c... . <br />State Cert. or Re818t.. ~.,e., OO'~.2.aq <br />. tJllhf ___..___ Oity License Reaistration . _ ~(" q <br />, ~................*............***...... <br /> <br />::::w , <br /> <br />PWOIIt J k/ CotlP,",Y_~ C 01...6.., JA" N. 5 <br />",/ /1, I State Cert. or Reat8t. '-B.E~ 00/.,(". 4'{., ~ <br />Sianature ,~_ .,.____ City LicettrJc R&lliatration . .. / '" b <br />~ .. ..................................... <br /> <br />Siaoature <br /> <br /> <br />OOH.PANY .. ...'5QUTJjEJlltN COf71Eg~:r E'N-r. <br />Stat.e Cr.rl. or Realst.' KA~ (')()Oa 9 <br />City License Reaistration . 6-3 <br />............................*..... <br /> <br />IlECIWII~ <br /> <br />0TRIl1l _ K 0 Q F <br /> <br />.Mfy_ CIA:551<;;. rJS'(7)t;;~ of :r'::>EoJ, 8y LI9~t'i-'N <br />Stat.e Cert. or Resiat.. '~.co Y~8~l.. <br />City Llceu8e Registration '.. t &jc9- <br />......................................... <br /> <br />Sl8D8.ture <br /> <br />APPLICATION APPl<<1VED BY _____.___~ ___~__ . <br /> <br />PDKtT OPFICER. <br />