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• <br />• . -. ~_. <br />• r <br />O~~li:~ L ~~y :. <br />/. <br />%'%~~~~~ ~.~ -~ fit - o~ ~,~~ forte <br />~'SXP9 <br />~~ RECEIVED <br />i~ISi'ECTiONS 8 <br />Building Mechanical *Electrical *Plumbiag <br />(* See back of form) <br />Project Address: ~~~ Pi'c~e_ 1~~~~~~ o~~. Lot: ~'~" <br />Subdivision: ~(~ Q ~T \~\'Q\~.1 ~PinE c31uf-~~ <br />Block • 'R <br />Owner's Name : t` \\ \ ~Ph[one <br />Address : ~~~ ~\~~ ~~.~~~~~ . c,~4 ~T _ ~ /~- ~~~~ 1 <br />Street City ~ Zip <br />Contractor: Phone: <br />Address• <br />Street City Zip <br />Engineer- <br />Designer: <br />Building IIse: K~_es i d e n.cc Sq. Footage: # Stories <br />Valuation : Describe Work : ~ R i rLQ Q_ h ~ MI PhAb, J B <br />J'~-~ rr~ e, d-~4- r-~o l c~c e. w h. o,r,~ e. he rn. y v e a~ ; n R~ h i I o F_ i lh~X a~ t 9 9 (o <br />For City IIse Daly <br />Occupancy Type Flood Zone Class Work <br />Construction Type IIse Zoae ~~ # Stories <br />Commercial Buildings Plans Oa1v-Fire Marshal Approval _ <br />Sq. Ft. <br />Parking requested_ <br />'"'-"-' Date : ~lZ= <br />Checked/Approved for Issuance By: Date: .._.___. _ <br />9 -- <br />Permit Fee ~ (attach to actual :~~~: ~-n~ ` ' <br />Revised J5/12/96 .u.: <br />~er.ac- <br /> <br />Permit No. - <br />