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813asaaozo Ci#y of Zephyrhilis Permit Application Fax 813asaoo2�
<br /> ` � Building Departmen#
<br /> Date Recatved _:.a f ' -� . � ' �"' .
<br /> � : C,�' ' •<�RFione Goritect'for'Parmittie �:' �
<br /> Owo+�r's Name �^ t'IJ . Owner Phone Number = �
<br /> Ownar'sAddress CG n+ �OwnerPhoneNumbat � ' �
<br /> Fee Slmple TiHeholder�Nam�= " � ' � � " OwnerPhone Namber � .,_�, 1
<br /> Fee S(mple Titleholtler Addre�s ,. ' N� ''•'�= � �
<br /> JOB ADDRESS „"• . , r(,�,^ , L01"# �: ,
<br /> SUBDIVISIQN � N�� , , PARCEL'ID#' �~ •~ �_ Cr^�U�'°"O "`"
<br /> „ , : - ":�('08YAINEDFROWFPROP.ERTYTAX�NQTlGB)
<br /> WORK PROP.OS�d "� NEVv CONSTa '� ADDIALT �Q SIGN [� [�"_l DEMQLISH � , ,. i
<br /> .. ' e .. ,.INSTALL -. '�REPAIR , _, . ,
<br /> PRQPOSED�USf.- , Q; -SFR Q 'COMM` � OTH�R� ,. . ,. , �� . �
<br /> TYPE OF�ONSTRUCTION:=`.'�] ` „�BLOCK��'.,`,�]:� FRAME � STEEL C]` '.r
<br /> DESCRIPTION�OF WORK Y'_ 4 , ` ` . a7`b� � '�
<br /> BUILDING°SIZE-���� �`6Q FO,OTAG_E,���� ' , ,.HEIGHT_. _
<br /> C�B~UILDIhIG $ � �-�w�,:r-., - �=;;,... . .
<br /> , �� VALUATION`�OF TOTAL'CONSTRUCTION
<br /> � .. ..
<br /> [�]ELECTRICAC $ AMP SfRViCE Q PROGRESS ENERGY �] W.R.E.C.
<br /> ' ��" � :
<br /> oP�:��$��� ,:$ . . . .. � f
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<br /> [�MEC3iAiVlCi4� $ , V,41.ClATIOIV;OF,..MECHAh1tCA�.tNSTALLATION �," - c� /}l� �( ���,�
<br /> .. � . ' � ,�`�"'aQ.� ►Y" r�.,,�,�,�,�''�"
<br /> 0�$ ._ , 0 . -,Roa��N�::�:.:p - s��c�A�.n.� o�ER -;� ' -S��`
<br /> FINISHED FLOOR EI.EVATIONS FLOOD ZONE AREA , .��YES. NO � ��
<br /> . ��<.. � • � • �
<br /> , BUIt�DEit CQMPANY � " . .
<br /> SIGNATUR� REGISTERED , Y/ N. FEE CURREP�,�, .Y/,N. _ � : , .
<br /> Address - `l� • .L.Icense# � - �
<br /> I , �,y. � . .
<br /> �' -
<br /> ELECTRICIAN�;:;;..;', . ' ' CCENiPi�NY f . ,SL��
<br /> SIGNIiTURE " itEGIS7eREn Y/ N �En: /N
<br /> Address a �' ec - ,�s('q , . , .-.L-Icense#•»� G�130 7�""L� �
<br /> �—
<br /> P�Ui1�8ER ..., . - - COI'fAPANY;`: .;,;>' - ._ �
<br /> SIGPIATURE ` ' �� ' :R6c31STEREO� ,, �:.Y/M,N_-., , FEE.CURrtek= . ''Y/N;~ �
<br /> Address �i� -. �
<br /> . , , . ..Llcense#;� .
<br /> MECNANIGAi:' � � _ ._.. ,!' � :.GOMRANY.. � _` � .. �,.t ;. -... _ - , .
<br /> SIGIVATURE ° <`�:' ' `-. , - � " �' � REQISTERED:,, , YY:/'N.= , ::�.CUR►tEn. _ =Y/N�•; ,. .
<br /> �ddres�'� .,; , �.: �} ' .�_ .. ,- , � ,- . ° .. .- - - �. .License# � - ;�
<br /> � .f.. — � . � �/ - . �.. '� ' . o z✓ .,- . .. : ..
<br /> :,:�.�- :ca�nPa�x
<br /> o�t�� � . ,.. � r , ., .. x .. . . -x:-:. _ .. .
<br /> SIGNATURE. - - � � - „�,* . � . ' ' .itEQis7E�n � _ Y/�N_ .-��;GuR�n� :Y./�N:: .,
<br /> Addr�as - `:s'_ �..?::,;y, :E�<. 'f,_ . . �,-;. „ . .. - . � - f.,,.R, ., - ;� _._ �
<br /> � `Uaense#
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<br /> RESIDENi'tAl:-:,:=:�At#ach..2 Flot P.,lans�;:� �:sets=ofi�8u�ldi'rt Ptans.�1 set`bf�Eiie'``�Fartn�•=R-0=VH°Ferfiiiffcr rie`�co'strucUan".�.
<br /> ..t_ ._ ., .._ �..t }....,.. �t2}. .. _ .A.. ,{ ), ., . �9Y ,.$, , . .. .,_ .,. -. ...w..;n,... - , ,,. -
<br /> ,�.M1Mlnimum,r,ten�(�10)�wo,Ncing;days�atter:"s"utimittal�clate:;Regulted'onsite;�Consfruadon�Plans;;T3tomnwater'PlanswfSllt Fenc�dnstalled,
<br /> .....- .Saaltary FautiUes�4�du,r�t�}stsrtSite Worfc?Per,tiiit_for.sutidlvislOnstiarge'projec�s:;;<�:},{a ' :_``.-` '� ' ='::- . ._ �- ._
<br /> COMMERCtAL Attar�(8j`wmptete"sefs'of Suilding'Plans ptus a'Llfe Safety�Page;(1)set of Energy Forrns.R 0-W Permit for new co'nstruction.
<br /> Minimum ten(1 Q)working days'after subm(ttal date. Requlred onsite,,ConstruaUon Plans,Stormwater Plans w/Slit Fence installed, ,
<br /> Sanilary,Fadtitles 8 i:,dumpster.<.SitemWork.Perrntt�for�al!new:prrsJeetskAti`commer�lai:cequl�et►tenfs-rstust•meet complEanca 4
<br /> .,StGN PEftMiT Attac�i(2j seis of'�nglne�i,ed;Pla[�s::�,,:�-�cr�'r�" .. _. , '.., - ,, . � ' = - . ,
<br /> `""'PROP.ERTY..SURVEY.raqulred for,all NEW.:construction:..,� •- ' '"'" ="�= ' - . _ .. •
<br /> Dl�ections: „ .��v ,�,y.. < . :.. . ._. ,.._�__ _._ ..� ___ ..
<br /> Ftll:out applicatlon completely.
<br /> Uwnsr Q Contractor s[gn hack of,�applicatlan,nataeized
<br /> If over�2500,�Notice of Commencemant_is required. (AIG_upgrades over 57500),_ _, f�
<br /> .. ::r,:.';.:�.�;::.�'h.._;. _,.,_.r,..K_... __�._�__. _.
<br /> Agent(fac the contiaclbr)"or'Power'of Attorn'sy(f6t�lhe'owrier-)would`be sameona.wfth nata�ized tetter from owner authoriztng same
<br /> 'O,,VER'7HE�COUNTER:PERMITTING��:=:.={Front:of ApPlicatlon On�y) � , �- � j .
<br /> Reroofs If shtngles Sewers Service Upgrades A/G Fences.(PlodSurvey/Footage) -..
<br /> _ °;,�:;:;','t':.,,_;:.:_�.:>��. , : . . , . _ ,
<br /> prlveways-Not aver Caunter If on•public roadways..needs ROW
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