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813-��� City of Zephyrhilis Permit Appliqtion Fax�1378Q0021 <br /> Bulding DepaM�eirt <br /> Date Received �—+/ � phone Cor�et for PertniKin S� Ga`� _�'oo <br /> , Oiwner'sName �1 e��,� ���e OwnerPhoneNumber g�3_�9�-5»3 <br /> OwnetsAaaress S��o� ��'�-~S�r z�hurh'.11s��. p�erPhoneNumber <br /> Fee Simple Titleholder Name N� ?J� Owner Phone Number <br /> FeeSimpteTitleholderAddress rl�NL" <br /> roeaonrt�ss 5aa-1 1�'�'�S� z e(���-l�t�lS �� 33s�Z �ors C�� 7 <br /> susnmsioN C'�L o� e,n h�-•�`.l� PARCEL IDa �1 - 2 L�-2\-U o�Q _\q�o o-o o e o <br /> �oer�wm�eao ama�rzrr T�x Koncq <br /> WORK PROPOSED � NEW CON57R 8 ADp/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> 1YPE OF CONSTRUCiION Q BLOCK O FRAME Q STEEL Q� <br /> DESCWPTIONOFWORK a�?�30 �e--l��.eo2 C�c 2� -�=o� c5�a(� �, <br /> BUILDING SIZE ���3� \ SD FOOTAGE ,S� H9GHT � <br /> UILDING 3 � ��� VALUA110N OF TOTAL CONSTRUCTION <br /> QELECTRICAL 5 ���� AMP SERVICE Q PROGRESS ENERGY Q W.RE_C. <br /> QPLUMBING a N��� ��J ���J <br /> QMECHANICAL S � � VALUATION OF MECHAMCAL INSTALLATION � / <br /> p�as Q ROOFlNG p sPEcu►�nr 0 oni�a <br /> FINISHED FLOOR ELEVA NS �S v ROOD ZONE AREA �]YES NO � <br /> . BUILDER 1� �O COMPANY �-'�S L F-/o�i�YQ ��yl�/4 c�dS.G LC <br /> SIGNATURE ( �� � REGtsr�rsED Y/N �cuwten Y/N <br /> Address davs �S �w y3�� /�`+�PC�y L3�.S�� License� V-�G/.2SG99� <br /> ELECTRICIAN �� COMPANY <br /> SIGNATURE N� r�cisr6tm Y/N FEEwr�. Y/N <br /> Address Licensa 8 <br /> PLUMBER 1 I �� COMPANY <br /> SIGNATURE /V� �cisrEreEo Y/N �cuRrsen Y/N ' <br /> Address Lioense f <br /> MECHANICAL 1�L COMPANY <br /> SIGNAiURE �� �tsiHt� Y/N �cuw�n Y/N <br /> Address License� <br /> OTHER � J��� COMPANY <br /> SIGNAil1RE I�� rtEWsrmEo Y/N �cuRrse� Y/N <br /> Addfess License f <br /> 111111111111111111111�1111111111111111111111111111111111111111111111 <br /> RESIDENiIAL Attad�(2)Pki Pmns:(2)sels of B�g Plans;(7)s�of Enet�r Forms:R-4W Permit for new aoashudion, <br /> Mmimum ten(70)woAti�days aftcv submiqai date. Reqwred onsite.ConstrucUon Ptans.StomMrater Plans w/SQt Fe�e fnshalled, <br /> Sanilery FealiNes 81 dumpstec;Siie WoAc Pertnk for suhdivisionsltacge projeds <br /> COMMERCIAL Attach(2)complete sels of Bu�ding Plans ptus a Life Safety Page;(1)set of Energy Fortns.R-O�W Pertnit for new construdion. <br /> Mmtmum ten(10)woAring days after submiffai date. Reqidred onsite.Caistrudion Plans.Stnrtmrater Plans nd Sat Fence insfa0ed, <br /> Sani[ary Faplities 81 dumpster.Site Work Pemtit for all new projeds./W commerdal reqiri2meMs must meet c�mpfiance <br /> SIGN PERMIT Atladi(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY requQed for afl NEW c�struceioa <br /> Direetions:• <br /> FlII out ap�cation completey. <br /> Owner 8 ConUactw sign badc oF applicafion,notarized <br /> If orer:2500,a Notice of CommencemeM is requ7red_ (A!C upgrades over;750D) <br /> " �qe�rt(for the contrador)or Power of Attomey(for the awner)woWd be someone with notarized letter hom owner authamng same <br /> OVER THE COUNTER PERMIT7ING (copy of coMract tequired) <br /> Re�oofs if shingles Sewers Servi�Upgrades AIC Fe�roes(PIoUSwveylFaotage) <br /> Driveways-Not over Counter if on p�fic roadxrdys..needs ROW <br />