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<br /> $13-780-oa2a Ci#y of Zephyrhiils Permit Apptication Fax-a�saso-oa2�
<br /> Building Department
<br /> $
<br /> � Date Received -
<br /> Phone Contact for Permittin' ��,.�� ' — �n ��
<br /> pwner's Name'. ,' r✓ ';�', ` ' ..-: q'Ovirner�Phone Numtier;.. M�}��v�r
<br /> �; ;;: �' : ;�.i,.:: ;;:! :;._,°,<:.•� ,,.:,,• ,{. : �
<br /> , . :t� - 7'+ :e; �-�`:i;�J::t;':z��': t,.� - �
<br /> Owner's Addreas` � �:Qwner�Phone Numtier` `� '�
<br /> .-,.: ��.:,
<br /> Fee Stmple Titlahoider.Name � �*Y AM1Owne,r�PhonehNum6er`'�-4 �
<br /> Fee Simple Titleholder Address
<br /> JOS ADDRESS r �� � r �� I.Q;# ���
<br /> SttBD{VISION � ` �� PARCEI�tD# ' — —Z -= U — ^ J
<br /> . (OBTAIMED FROM pROPERTY TAX Np710E)
<br /> WORK PROPQSED - e NEW GONSTR 8 >ADDtA�T` � SIGN� Q Q` DEMOLISH
<br /> INSTALL- . REPAIR
<br /> PROPQSEd USE� Q SPR Q CQMM Q OTHER
<br /> TYPE OF CONSTRUC"I`ION Q BLOCK' Q " FRAME Q STEEL Q.
<br /> DESCRiP'f10N�OF WORK � �) i V e i
<br /> BUILDING SIZE' � �, SQ FOOTAGE��_!��:, HEIG}IT �� -
<br /> QBUILCtING � VAL(1A710iV'OF 70TAL C�NSTRt1CT10N
<br /> . � � 00•oa � - - � .
<br /> QELEGTR1CAt. . �$ . � �AMP SERVICE Q� PROfiaRESS ENERGY �[� W.R.E.C.
<br /> �_
<br /> QPLUMBING �-----T� i�r� '�
<br /> � ` a
<br /> QMECHANICAL $ VALUATIC}N OF MECHANlGA�►NSTALLATlON
<br /> QGAS [� ROOFiNG, Q SPECIALTY � OTHER �(/'!U � (,,tiJ(f��j S
<br /> �
<br /> FINISHED FLOOR ELEVATIONS FLQOD ZONE AREA [�YES NO
<br /> . • t .
<br /> BUI�DER �,,, CBMPANY � (/' 1 , t
<br /> SIGNATURE /' ' REGISTERED N �FEE CURRE� Y/N
<br /> Address Cice�se# � �
<br /> ELECTRICIAN. GOMPAElY - .
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address L•icerise#��y �
<br /> PI.UMBER . £OMFANY `
<br /> SIGNATURE ReGisTeREO. Y/ N. � FEE CuRREn�; Y/:N
<br /> Address `� � ,Ltcense# ( � �
<br /> MECHANlCAL ` COMPANY �,w �
<br /> SIGNATURE � � � � � "° aecisr�RE�� , ,Y/ N . F�E cuRR�n; . Y!N .
<br /> Address � - � � � , � ticense.#.� �
<br /> C}THER � ' `"° COMPANY � �
<br /> SIGNA7URE ' ' � - REGISTERED `� Y/ N FEE CURR�� Y J N.
<br /> Address. : ,, - . �. _ � -'Licehse#�� �
<br /> . , .. ; _.
<br /> liESIDENTlAL .��Fittach{2);i?1ot�Plans,'(2)'.sets�of:Builtling�Plans;{'I),setofEhergjrFarms;R-O=W�Perinitfornewcanstruc�an, - - ` -
<br /> , �Minimum ten;(�1q),-working day.s�after submittai:date:`Reguired:onsite,',Constniotian Rlans;SformwaterPlans w/Sflt Fence instaNed,
<br /> Sanikary Facil(ties&�1:;dumpster;•:SIte�lNork�Permit,forsubdivisions/large;projects ; �`- � ��� '
<br /> COMMEI2CIA4. Attach{3}corriplete'sets of Ballding°Plans'plus"a'l:ife'Safety Page;'(1)set of Energy Foims.#2-O-W Permit for new constructian.
<br /> Minimum ten(10)working days after submtttai date. Required onsfte,Constructtan Pians,Stortnwater Plans w/Silt Fence instaited,
<br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new:proJects:Al4commercial requirements must meet compBance
<br /> SIGN PERMiT Attach{2)seis af Er�gineered�Plans.. :_ ' - � - . `
<br /> ""PROPER7Y SURVEY requirecl for�all NEW constructian. ,
<br /> 5lrections: , � -
<br /> Fill aut-applicatlon completely. ,
<br /> Owner 8 Cantractor sign back of epplicatian,notatized
<br /> If over�2500.a Nottce of Cammencement is required. (A!C upgradas ovsr��500}
<br /> " Agent(for khe'contracto�)�or'Rower af Attomey(forthe-owner)would�be sorrieone with notarized letter finm owner authorizing same
<br /> 3VER THE CQUNTER�:PERMITt'tNG_. .___...{Front.of.Appticafion..Only). �
<br /> 2eroofs if shingles Sewers Service Upgrades A/C Fences(PIaUSurvey/Footage)
<br /> Qriveways-Not over Caunter!f on publ[c r+oadi+vays::needs'ROW � �
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