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i <br /> e�a-�so-�zo City of Zephyfiilis�f'ermit Application F„x$��-7so-oo�� <br /> e��ai�oa�,�c <br /> D�,tv Rocalved phonc Coatacttor Pertnittin �6� �� — ��¢�(] <br /> �Q-a c-ra rr-n <br /> a�„ar�n+,�,a h� ���1 I Owner Phone Rlumher <br /> /� /7 + t a <br /> OvJrror's AEdr� l!��� �r l 1 � . I Ot�r+or Phono Idumbar <br /> Feo Sfmplo Titiaholdor Atamo I Otv�ar Phoao Number <br /> I <br /> Fee Slmp°a YitlehotCor.Addrens I <br /> .�B�D� (n o l� � � ! t il i �e h� `� f. 5 �� LoT� � <br /> � <br /> StJSDINSIOtd � PARCEL ED't <br /> iOHTA10.'ED FRO"d PROPERIY L1F HOi1C� <br /> WORKPROPOSED Nt1N[oNSiR �/ A�DlALT � SIGN Q Q DEMOLISH <br /> e INSTAI.I. REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHEFt <br /> TYPE OF CONSTRUCYlON Q BLOCK � �M9E Q STEEL Q <br /> DESCRIP780N OF WORFh G�'��.���� 6r�.°�1 n V'I .' ' � ' �� ��i�� �G'i��'1 <br /> BUIID�PiG SIZE SQ FODZ'AG�� F�I�HT � <br /> OBUILDING S /r —7 � VACUATIOM OF TOTAL CONSTRUCTiON SL�y� �� <br /> �J� /� <br /> QELECTRICAL $ r(O/ti AMPSERVICE Q PROGRESSENERGY Q W.R.E.C. <br /> �-1 C1 <br /> op���B�,� g �� �36 � vg� �r <br /> ��J ` (� �� d / <br /> I QMECHANICAL S ���/y VALUATIOt�1 OF i HANICRL IiVSTALLATION �i ���' �0`^ ✓ <br /> ll � ♦�;a�� � �j, L� l <br /> QGAS Q ROOFING Q SPECIALNi� OTHER �� G-�"� � � L� F ' <br /> FINISHED FLOOR EI.EVATWTdS FLOOD ZO i E AREA QYES NO �,t�.�-' � � � <br /> 8�,��. �o��� F^�. �,d�n e.�� . � � . . - 3i ���J1 v+ <br /> SIG�AT1tRE � �.1� REGISi�EO Y!N rgCUa�C1 S�� (y�= ' 1 .��p;��/ <br /> V \ � Fr:� <br /> �ita.p�•o�a l ar�dr� � t S.�r�.S .� � �L€ t�—� ��55� ucenser. t'.���I � `2. y� w <br /> y . <br /> � <br /> �`�,�f��� SLECTRBCIRAI "` ��� co�,aPa�v �i Sl0 f��'�`�ic.c��+-�5b� �Ic°f-�-ri�C. . <br /> Si����a ,�GNATURE REGI6TER� Y! N �cuttx2t� Y JN <br /> I �p s �t'i�� Y�r}C�[l�G �'�� �� ucense s ���C�f�'J� <br /> � <br /> ��� PLllP96ER �J� i. �"n r'�1�{�� C063P� <br /> :. � �� SlGtdA711RE �31� �•C�,Y��— r�G�sr�m YJ N r�cuaf�n Y!N <br /> S l • �` , � Addro� I License:! <br /> n — <br /> . �j�. _._. � <br /> ,q. � EAEGHMtlCAi CQ&9P� , ,j <br /> I� � SlGNAlURE ftEGISiERED Y/IV FFECttAREA Y/f� ���f/�(lS�I� <br /> /AUCrJ�'iC�L <br /> Addreraa I License� fj�3:'�[-f�!-[JO Z 1 <br /> I <br /> OTHER COB9PASdY <br /> S3GRIAYURE REGlS'(ERm Y! N f�ECUR2=n Y/N <br /> Addtos� � Llmnse 7t <br /> 0 ➢ BdBii � LiiB1B80@BIBAOGIQ780EA8BABA �8B9111AASiSIlO � IIBIGiBlQ ! ➢ Yi0811 <br /> RESIDER117AI. Attach(2)Plot plans;(2)sets of Bra"Idmg Pian.;(1)set of Eneigy Forms;R-�-W PermR for new corissWction, <br /> Mir�mwn ten(10)rrwking days aRer suhmittxl date. Required onsite,Cnnstniction Plans,Stormwater Plans w/S�lt Fance instaltad, <br /> � Sanitary Facilities&'I dumpstar,Site Work Fermft fir suhdivisiurrsllarge pivJects <br /> COPakb3ERClq� Attach{�complete sets of Buitding Plorts�us a Lffe Sa�ty Pags;(1)set oF Energy Forms.R-O-W Permit tor rteraconstrudian. <br /> Mltdmtan ten(10)�vorktnfl days aRer submtt[al dale. Required onsite,cvns�n,cuon atara,Storrnvrater Plans w!Sdit Fetec.e I�stafted, <br /> Sanitary Faclitties&t tlumpsler.SBe Work Peimlt for nA i pro�ects.Ail comrrterctai requlremeMS must meet eompthnce <br /> SlGf�PERi'Ai'� Attach(2)sefs of Engltteetpd Plans- <br /> ""PROPER'[,Y SURVEY requhed for.II NEVII cortstrudion <br /> E'�d'..&�."�9�°1+A.��2�3_,:_._ �_$ ° - - - - "I'.°ae° - - - "- ' - "• 8 - - - - - <br /> Qiteetioers. e� <br /> Fili out applicatian completety. <br /> Oirmer&ConUactor sisn budc of 2ppAcaflon,not2flzed I <br /> tf ovor S25Qa,a Natlao of Commorteomont NS roqulrod. (AfC upgrnd�i ovor575aD) <br /> " Agenf(tor Vte contracto�or Potiver ofAtlomey(for the owner)xrouSd be nameone wEth nafarized lefter from owner auihoriang same <br /> oVER 7HE COt1nRER PER['�ITTiAiG ¢ront of Appilc�tion Onty) � <br /> R�ooFs if shingles SeVeets Senrtee Upgrades WC Fences(Plol/SurveylFaalage) <br /> Drivcr,r�Not over Counter Ef on aublia road�vavs..�eeds ROW <br /> i <br />- � <br />