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a��-rsaoozo City of Zephyrhiils Permit Applicatian Fax 8t3-78Q-0421 <br /> ; ;, Building Depariment <br /> Date Recelved . Phone Contac#far Permitt€ng ��� ��� – J�f� . <br /> Owner's Name 1��" �.'` �X7 Owner Phane Number ��a � ��� " <br /> Owner's Address �c��c� j+ ���� �� 'Owner Phone Number � � <br /> Fee Slmple Tltisholder Name � � Owner Phone Number �� � <br /> Fee Simple TitlehoSder Address <br /> �/.y )f� L j���/ <br /> JOB ADDRESS /vR �a� r/"/ F1`uN �A� Lt?T# <br /> SUBDIVISION ��JK /C"L�J� ��� PARCEL ID# �T o?J""� .v�f C��GgD DL�GYQ �C�O� <br /> ' �(OBTAINED FROM PROPERTY TAX NOTICE) ' <br /> WORK PROPOSED e NEW CONSTR�ADD/ALT 0 SIGN Q Q DEMOLISH <br /> INSTAIL REPAIR <br /> PROPQSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CdNSTRUCTiON [� B�OCK � FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK ��-°l�7b��.,.° ��E /GLG'CG EJ�?'� G(�/?7 " o� ��'� dN��V Z�� o� I !J'� <br /> BUILDING Si2E � � SQ FOOTAGE�� HEIGHT [,�� <br /> QBUtl.QING �> � VALUATION qF TOTAL CONSTRUC710N <br /> QEIECTRtCA� � � AMP SERViCE Q PRQGRESS ENERGY [� W.R.E.C. <br /> QPLUNi81NG ($>� <br /> � <br /> [�I MEGHANICAI $ ����+ �D VALUATION OF MECNANtCA�INSTALi.AT10N <br /> QGAS Q RQ4FING �) SPECIALTY Q OTHER <br /> F(NISNED FLQOR E�EVATIpNS �� F�OQD ZONE AREA QYES NO <br /> BUEIDER COMPANY <br /> SlGNATURE REGISTERED Y! iV FEE GURREM1 Y!N <br /> Address � License# � i� <br /> ELECTRtC1AN GdMPANY <br /> SiGNATURE REGtSTERED Y J N FEE CURRE� Y/N <br /> Address License# �— �� <br /> PCUMBER � � COMPANY <br /> SIGNATURE � REGfSTEftEO Y I N FEE GUi2ftER Y/N <br /> Address License# �` I <br /> M�cNa�rica�. coM�ar�r ��f�'�� � ��/�c�',►�(� <br /> SIGNATURE ��"�4�'��'' REGISTEREQ Y/ (1! FEE GURRE� Y 1 N <br /> Address License# �/��� '�..���� - � <br /> 01'FtER COMPANY <br /> SIGt�ATURE REGlS7ERED Y f N �e�eu��n Y!N <br /> Address License# ��`�� <br /> � R�SIDENTIAL Attach(2j Plot Plans;{2}sets of Buflding Plans;{1}set af Energy Forms;R O-W Petm{t far new construction, <br /> Minimum ten(10)working days after submtttal date. Requtred onsite,Construc8on Plans,3tormwater Plans w!S(It Fence installed, <br /> Sanitary Facili6es&1 dumpster,Site Work Permit for subdivislons/large projects <br /> , GOMMERCIAI Attach{3}complete sets of Butldirig Pfans pfus a life Safety Page;{1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal data. Required onsite,Construc#tart Plans.Starmwater Plans w!Silt Fence InstaNed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet comptiance <br /> � SIGN PERMiT Attach(2)sets of Engineered Plans. - . <br /> '•""PROPERTY SURYEY�equ[red#or all NEW consttuotion. <br /> Dlrectians: <br /> Fill out appUcatian campletely. <br /> C►wner&Contractor sign back of applicaUon,notarized , <br /> If avsr 52500,a Notice of Commencement is required. (AIC upgrades over 57588) . _ .�r� ��' °_ - <br /> " Agent(fbr the cantractor)ar Power of At#omey(for the owner}woutd be someone with notarized tetter from owner authorizing•same' ' � <br /> , , ,'r .. . <br /> DVER THE COUNTER PERMITi'tNG (Front of Appiication Only} ° � <br /> Reroafs if shingEes Sewers Service Upgrades AtC Fertces(PIoUSurveylFootage} � ' , _ z � - <br /> � Driveways-Not aver Counter if an pubtic roadways..needs ROW <br />