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e�s-7ao-oozo City of Zephyrh�lls Permit Application Fax 813asaooz� <br /> ; '� 8uIldi g Departtrtent <br /> Date Reeetved � � " �1 phone-Cantact for Permlttin - <br /> . � � ,,.. � �a o ��'' • fd' <br />''i Owner s Name (�i m./" Owner Pbone Nurt�ber <br /> Owner's Address � �G1 da✓ �G'� Owner Phone Numlaer � � <br /> Fee Slmple Titleholder Name ���'�f .�`"b�"�"'' Owner Phone Number � � <br /> i <br /> Fee Slmple Tltleholder Addres� <br /> JOBADQRESS �� U ��'�` LOT# [___� <br /> SUBdIVIS10N �— � PARCEL�d# <br /> (OBTAINED FROM PROPER7YTAX NQTICE) <br /> WORK PROPOSED , e NEW CONSTR 8 ADDIAL� � 51GM1f � Q pEMOLtSH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFi2 Q COMM Q QTHER <br /> TYPE OF CON3TRUCTION Q BLOCK Q FRAME� � $TEEL Q <br /> DESCRIPTION OF WORK ,�dl u'� `�t'"r"� O p� � �! �,T //�J <br /> BUILDING S1ZE C�� ��� SQ FOOTAGE ���O HEIGHT �_____ry� Y� <br /> D�U��'����' ''������1���,,_ � VAtUATIOtV OF T07A1 CONSTRUGTION 77" '� � ' <br /> L �J <br /> QELECTRICAt � � AMP SERVIGE Q PRC?GRESS ENEf2GY Q W.R.E.C. <br /> QPLUMBING �6�� ` <br /> QMECHANtGAL $ VALUATION t3F MECHANICAI.INSTAILATlON � ����'v <br /> QGAS Q ROOFiNG Q SPECI LTY � OTHER <br /> FINISHED FLOOR ELEVATIqNS ��� FI.00D ZQNE AREA QYES NO <br /> � <br /> G > ��' z �� <br /> BUI�DER CO PANY � / �yr <br /> SIGNATURE REGISTERED Y/ N FEE CURR Y./N <br /> Address � License# � � � <br /> ELECTRICIAN COIMPAHY <br /> � SIGNATURE REGI5TERED Y/ N FEE CURRE� Y/N <br /> Addre�s ' � Ucense# �� j <br /> PIUMBER . C�MPANY � <br /> SIGNATURE REGI5TERED Y/ N FEE CURRE� Y/N <br /> Address � License# � � <br /> � <br /> MECHANICAI. CG}MPANY <br /> SIGNA7URE REGISTERED Y/ N FEE CURRE� Y/N <br /> i <br /> Address License# �—� � <br /> I <br /> QTHER COMPAt�tY � <br /> SIGNATURE REGI$TERED Y/ N FEE CURRE� Y/N. <br /> Address I license# � � <br /> REStDENi7A1: Attach{2}piat Plans;.(2}sets af Building'Plans;{1}set�af�nergy Farrns;R-O-W Permlt for new constructlon, <br /> Minlmum ten:(1.0)woricing'days after..submittal date. Requlred onsite,Constructian Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitery Facilides&1 dumpster;Site Wotk Permit for subdiVisionsAarge.projects - - <br /> C4MMERCIAL Attach{3)compiete sefs�isf Su[Idirig Pians ptas a l.ife Safetyr Page;(1}set of Energy Fotms.R O•W Petmit for new canstrucHon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Constructian Plans,Stortnwater Plans w/Silt Fence installed, <br /> SaMtary Facllitles&1 dumpster.Site Work Perm(t for all new proJects.All commercial requtrements must meet compliance <br /> StGN PERMIT Attacli{2}sets of Englneered Plans. <br /> "*"PROPERTY SURVEY required for all NEW const ctlan. <br /> Dlrectlons: <br /> Fill out applicaUan completely. <br /> Owner&Contractor stgn back of applicaBon,notaiized <br /> if over 52540,a Notice af Commencement is required. {NC upgtades over 57500j <br /> " Agent(for the contractor)or Power of Attamey(far the owner)would be someone with notarized letter from owner authorizing same <br /> DVER THE COUNTER PERMITTING �'(F�oiit of:Applida'tion Only}"°.';;°%';��•��,; , <br /> Reroofs if shingles Sewers Seivice Upg�acles;A/C'.�' Fence �(PIoUSurvey/Foatage) <br /> ; . , r,:' .��:; .,;, �;_, . H <br /> �:� <br /> Driveways-Not over Counter if an pubNc,�roadway`s::need`s`ROW� "' = <br /> . ....�<....._.,w•�,,, .,. 4 ,-�.�, , ,.;,.M..� <br />