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a��-�saoo2o City of Zephychills Permit Application Fax s�3aso-oo2�
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<br /> ; • 8ullding Departrnent
<br /> Date Received • -� :�}�
<br /> _ - -� - . Phone_Confactafo�'Periiiittin -- - _..<. ._.... : ,.�-. s__._ �._,� ,---,�
<br /> Ownec's Name _ .../v,� � � . W� S _. .. _ „�, : .. _ . .. _ � . .. 4.2—Z�
<br /> .�,r�= OiiJner Phone�Nuniber� 3�� �
<br /> Owner's Address ` � ' 2� � -� $ . ; � . ,.�Owner•Phone Number;-_ �✓~.~y } , �- � - _ _ ,
<br />� Fee Simple Titleholder Name � � Owner Phone Numbe�
<br /> , .�. _ ... ,. ,. �_ . __ ,, , �,
<br /> Fee'$Imple.Titleholder'i4ddress � � , � - ` � _: �'- .,>„ -. ;.__ �:.-.v_w.. ,._ ._:.�_ ._:_. ..��_ _.a_
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<br /> JOB ADDRESS ��Z� ��� - � LOT# �
<br /> - SUBDIVISION� .. � } ,PARCEL ID# ` ,, .,... .,r-_:,.��: . .. -- , .=_� �., __ ..
<br /> � , „ . - 4:�^�,` .. .....� �� ":(OBTAINED FROM�PROPERTY TAX NOTICEI.;:'`.: -. .� ;,
<br /> , � .. , _. �:..,,�_- ..: „;, :. . .,:.�` : . _.
<br /> WOR6C:PROPOSED , . _ �_':NEW CONS1'R �.'.�:::,.'�ADD/ALT - .Q:� SIGN�•`":Q'"�„�` ,,:'_ ,:Q" `-�'DEMOkISH :
<br /> INSTALL � e' -REPAIR
<br /> :_, _ - '
<br /> PROPOSED USE� , , � - 'SFR �`[� ' �`COMM Q;.'`OTHER . � �, --,.
<br /> TYPE OF CON3TRUCTION`, ' ,.:BLOCK`�' 'Q'� ' �FRi4ME � ,Q.. STEEL °Q::�_ , " ._s r.'.,.,` - - ..
<br /> ; . , „ _ �!f _ . ` � � . _. - . • . : _. : .
<br /> DE3CRIPTION OF WORK ��R�.1 _.l��(c�l � , �� _ .
<br /> ,..: , _ .:. ,. .
<br /> .,, �-d:.
<br /> . ;.. - , ... , ._
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<br /> BUILDING•SIZE'' ` '" ' ;. � � SQ FOOT GE: y I�0- L�� H �:6� .F; . .
<br /> . , _ EIGHT ' _ -
<br /> ,� -
<br /> .. , ,;� , - �.,
<br /> QBUIL'DING� . $ � �mr:..:-;;,,' . ..-•_�• -,.- . . - .
<br /> - � � • �r��'Q(� 'VALUATION`�F TOTAL`CONS`I'Rl7CTION�i .
<br /> QELECTRICAL . •_ $ �'�'-AMP'SERVICE Q; PROGRESS ENERGY :Q �,W.R:E:C.
<br /> QPLUMBING. . $' ,
<br /> . . . : �� � 3�3
<br /> QMECHANICAL $ � ,�.VALUATION OF MECHANICAL INSTALLATION
<br /> QGAS �Q, ROOFING...�Q: -. SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS � ' FLOOD ZONE AREA QYE$ NO
<br /> , �. < <� _ ,
<br /> BUILDER � ' COMPANY � ��1� F(rl�P
<br /> SIGMATURE REGISTERED Y/ N . �E cutsten ,Y L N:;: . � •
<br /> Addres� , �� "vV.�. � , � License#
<br /> ELECTRICIAM ' COMPANY '� � .- �
<br /> SIGNATURE - ' �' REGISTERED Y/ N FEE GURRE�-. Y/N ,
<br /> Address � ' - .a : �.Cicense#� ` _ : ��� � ,
<br /> PLUMBER ' COMPANY< . .• ' .
<br /> SIGNATURE � � :. .REGISTERED - •"»rY-I��N �:�. ,� FEe cuRrtE�. �`X/N; .
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<br /> Address , . � .-- :License#= : . .. �
<br /> .-,�;�;==-� , . _,_:._ - . ., ,,: ., ... - ... . .
<br /> MECNANICAL " . . �,.,COMPANY����
<br /> SIGNATURE � ` -REGI,STERED. � '�.Y;/-.N:;._-�,. :FEE,CURRE� ,• Y�%:{d`""..:�� ` � �
<br /> Address-- - , , . s . - .,. f _, _ � _ _ ,. , .-,.,..:.:_ ' -
<br /> . _. l:icense:#�.. _ - -
<br /> OTHER 'v " . . . ` ' � COMPANY.- - ,.,, - ... - ' ' -: ., � . ,
<br /> SIGNATURE' '= � � REGIS7ERED :._ . . _ � '-:s•, r ;>,: . .
<br /> ;Y./'-N:, _,FEE;Guw3E�f_ Y�/�Nr:='.
<br /> . ..., . ., . ., .. . . � .'.,i.i� .� ' . .. .� � r '• �
<br /> /7Y{Ir�W _ - -Y��'�r.R�':. . . � �` .a v. ... . ,
<br /> - .L�C@�$@#•
<br /> " .:�' _ 'r,+H'e...1�ir c�... " ;arr;e,ry.�;: ' �,.v,ih�o<;;-�'x^.'� R;,i`-:: � ' , . „ .' � . � _
<br /> �; 1'n k._ `�,12.+�..''?"<'i:�,5�'-.-
<br /> RESIDENTIAL�� �'Atta'o6;:(2)�PIot�Plan§;x(�2)`sets:of'Bullding:Rl'ans;:(1)set'of`Enerrg'y�Fomis;'�i-O=W°Ferm�itfor.neinc;conshiicf�on, - .
<br /> �-�.Minimum,teii�.1a%ieioikln "`d''`:atter;sCitimiftal'"dale:.R`"ulred onstte14Co�stiu'c8on'•Pl�n'�=' _ �`�!��'`"' _
<br /> _. ,.. ..�,,,.�.��.�.)x.m. _ 9��Y.s�., eq, a s;,S�tomiwater.Plans.wL:Sflk:Fence.installed,
<br /> `'SaMfe :Fadlldes�&�1�du ste�;-SIte:Woik;Perm1E` � '� " T�R�'�'^"~°•' ' - � . " ,
<br /> L ry ,;��..,r..,,�...<.;`,;���p•z =.��•_.�:.�••;�,a>��.::.:-�_,�°.�:..., �ge,:proj�..,,,:w`:..{,� --
<br /> , c:suti.dlv�,�s`Ibn&/la` ' " '"`"� � `'
<br /> COMMERCIAL Attach,(3)complete;sets�ofB�111dIng;Plans,plus.a�tlfe'Safe.tyPage;(1)'setof;Energy,Forms:R-O-WPermltfoPneW�constnictfon.
<br /> ' Mlnimum ten'(10)working dajis'aRer submltteF date. Requlred onslte,Construc8on Plans,Stortnwater Plans w/Sllt Fence Installed,
<br /> Senitary.Fac111das&,1:dumpster..,Site�Work Permlt�for a11'new;projecfs:�All commerclal requfrements:.must.meet compllance
<br /> SIGN PERMIT Attacti"(2�'sets of`Engl,neer,ed;PlaFis:��,�;�q ... -. ' " .- , ,; - - -
<br /> � ""PROPERTY`SURVEY`�equlred for`aII�NEW cor�strucUon.;. __ ,
<br /> Dtrecyons:. .- . - .,,.E�:,. - •; __ . .,. - . , • ,�f , . -. , , , ,
<br /> Ffll.out appNcatlon campletely. °
<br /> Owner,&.Contrector slgn back-of.applfcatlon,notadzed
<br /> If over�2500,a�.Notice:of;Commenc�ment.la requlred: ,(AIC,upgrades over 57500)
<br /> �R "i�K.;�"`i"�f:G9Y.+qf�7.}:: . . � . ... _
<br /> Agent(for.tfie contractor)'o7,Power of Attoriiey(fo�the`owner)would be someone wlth notariied letter.from owner autho�izing same
<br /> DY,ER'THE'COUNTER�PERMI?I'TING;�-- ; .(Front-cf Appllcation Only)
<br /> Reroofs:if shingles Sewers ,_ -� Servlce.Upgrades,A/C'`- - Fences(Plot/Survey/Footage)
<br /> Drlveways-Not over Counter.if on publlc roadways.:needs ROW
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