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<br />. t?~-# ifJj-q-13 <br /> <br />APPLICATIOII FUR PEFlfI"!' <br />CITY OF ZEPIJ:tRBILL5 <br />BUILDDIG DRPAKnIlEXT <br /> <br />OWNER'S RAIfE <br /> <br /> <br />ao-e- <br /> <br />LEGAL DESCRI.Pl'IOlIf: WI'(S) <br /> <br />BLOCI( <br /> <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />q-. <br /> <br />PARCEL LD.' <br />WRK PROPOSED:_5ev Construction ~dition _Alteration _Repair _Install <br /> <br />S. <br />- 19J1 <br /> <br />_!!love <br /> <br />_Deao1ish <br /> <br />PROPOSED USE: <br /> <br />Sing1e F:aaily <br /> <br />.' _KIF <br /> <br />_, of Units <br /> <br />_K/H <br /> <br />_<=<<-ercia1 <br /> <br />_Indust. <br /> <br />___Swia. Pool <br /> <br />Other <br /> <br />_Rest:auran.t 5: Hea1t:h ~t Approva1 <br /> <br />BUILDIltG SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />, RESIDENTIAL: <br />cottIIERCIAL : <br /> <br />A1TACD (2) PLOT PI.AlIS 5: (2) SEIS OF BUlLDlliG PLUl'S 5: (1) SEI' ENERGY FORKS. ** <br />ATTACH (3) Stmi OF BUII.DllIG PLUI'S ~ (1) SEI' ENERGY FORKS.*"" <br />**COFY OF CXlITRACT HIlQUIRED. <br /> <br />PERI!IITS REC'c;1J.ESTED <br /> <br />~UILDIltG <br /> <br />$ <br /> <br />Va1uation of Tot:a1 Construction <br /> <br />_PLUKBDIG <br /> <br /> <br /> <br />Corp . <br /> <br />W.R.E.C. <br /> <br />_ELECTRICAL <br /> <br />~CAL <br /> <br />Installation <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTIOR: _B1ock _Fraae _Stee1 <br /> <br />Other <br /> <br />FTIII.SIIED FLOOR ELEVATIOlIfS: <br /> <br />FT. <br /> <br />IS P.RO..JECT III FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />lDII'RACIOR SECTION <br /> <br />S igoat:ure <br /> <br />COIIPAJJY <br />State Cert. or Regist. # <br />City License Registration , <br />*****~************************************ <br /> <br />RmT .DF.R <br /> <br />ELEC'l1UCIAN COIIP.DY <br />~~ Stare Cert. or 1< .st.' <br />SiPnatur ... ~ City License Re stratioo <br />/ ****************************************** <br /> <br /> <br />COIIPMY <br />State Cert. or Regist. # <br />City License Registration I <br />*************************** ************* <br />I' t <br /> <br /> <br />KECHANICAL ~ aJ!IP. <br />/J 1.._ State Cert. 0 egist. f <br />Signature C-. ~ CHy License egist:ration <br />/ ****~.********************************** <br /> <br />PLUtlBER <br /> <br />Signature <br /> <br /> <br />COIIPBY <br />State Cert:. or Regist. ,,_no <br />_ _._.._ City License Registration , <br />~~*~*"".k*~~~.**************************** <br /> <br />omF.R <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY ___ <br /> <br />PRRl1:IT OFFICER. <br />