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s�aaso�ozo Ci#y of Zephyrhilis Permit Application- Fax-e�aaeaooz�
<br /> . Building Departrnent
<br /> Date Received phone-Cantact far Perm[ttin
<br /> Owner's Name ) �e.i Owner Phone Number 3 F� ���7..3
<br /> Owner's Addre�s I � 1�����• Owner Phone Mumber � �
<br /> Fee Sfmple Titlehalder Name � � Owner Phone Number �� ��
<br />� �
<br /> I Fea Simple Titleholder Address
<br /> I�' �1 � J a�� '`'J 4QT# �__�
<br /> JQB ADdRESS
<br />� SUBDIViS10N �� � PARCEL ID#
<br /> (OBTAINED FROM PRQPERTY TAX NOTICE)
<br /> WORi{PROFQSED NEW C4NSTR ADD/A�T � SEGN Q [� DEMOLtSN
<br /> e INSTALL e REPAIR
<br /> P320POSED•USE Q SFR Q CQMM � OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK " [� FRAME Q STEEL Q
<br /> UESCRIPTiON OF WORK ��S���'– � 1 I-�. �6� �SIL�C',. l9-I.JS•��• GGs�2.... O� �.1 Vr.7 ��
<br /> BUILDING SIZE � �.SQ FQOTAGE C_� HEiGHT �J �
<br /> QBUILDING � ��� �„�� VALUATION`OF'TOTAL CONSl't2UCT�ON
<br /> '�J
<br /> QELECTRICAL �� AMP SEF2VICE Q F'ROGF2ESS Ei�lERGY Q W.R.E.C.
<br /> i QPLtlMBING �^�
<br /> QMEGHANtGAi. $ VAt,UATtQN OF MECHANIGAL INSTA�tA7'ION
<br /> OGAS Q ROOFING Q SPEClALTY Q OTNER "
<br /> I FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA QYES NO
<br /> I� BUiLDER COMPANY
<br /> � SIGNATURE RHGISTERED Y/ N FEE CURRE� Y/N
<br /> ' Address L:Icense# � ��
<br /> � EI.ECTE2iC1AN COMPANY
<br /> � SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# i ��
<br /> P�tlMSER � CpMPANY
<br /> SIGPIATUI2E REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address i.icense# � � �
<br /> MECHAl+IICAI. COMPANY
<br /> SIGNATURE REGISTERED Y,/ N FEE CURRE� Y/N
<br /> Address (,���s�,� �— �
<br /> SIGNATURE ����� �`��� ��c� ��� R O�ISpER D Y/ N FEE CURRE� Y/N
<br /> Address 0 b �S'��S�:�� ]7k�:e �'c� j Lt"�'Z'C�' � 3 2,�J t f.c� l:icensa# � �
<br /> RESIDEN'TIAL• Attach{2}Pldt'Plans;(2}sets of.8iifiding"Plans;{1}set of Energy�Fotm's;R-{O-W Permlt(or new canstruction,
<br /> M'rnimum,ten;(1.0)worktng;days;after.submitta�date. Required onsfte,Constnictlon Plans;Stortnwater Plans w/Silt Fence installed,
<br /> SaNtary�FaciliUes.&=1,.dumpster SIte�Work;PeRnit far subtlivislonsAarge proJects
<br /> COMMERCIAL Attach(3)campfete sets of Bciildln'g'Plans plus a Llfe Safely Page;{1}set af Energy Forms.!2-O W Perm3t for new canstruction.
<br /> Minimum ten(10)working days'after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FaciliUes 8 1 dumpster.Site Work•Permit for all new proJects.All commercial requirements must meet comptiance
<br /> StGN PERMIT Attach(2}'sets of Engineered�Plans. ,, �
<br /> '""PROPER7Y SURVEY reguired for all NEVU construcUon. .
<br /> Diracttons: '
<br /> Fill out application completely.
<br /> Owner 8 Contractor sign back of appltcatlon,nota�ized
<br /> If aver$2500,a Notice a#Cammsncement is requiced. (AtC upgrades over b750dj
<br /> '• Agent(for tFie contraotor)or Power of Attomey(for�the owner)would be someone with notarized letter from owner authorizing same
<br /> 4VER THE C4!?N7EEZ-P..ERI4�ITi'ING (Pront of Appllcat�on Only) . . . �- • : .. , .;`-.. :":- �
<br /> ' Reroofs If shingles 3ewers Service Upgrades.,A/G _.,�n�Fences•(Plot/Survey/Footage) ' - "' �
<br /> ,... it� ,. . ':":: �; ' � ,� 't � . ,,' . ;�:,._ • . [{
<br /> DNveways-Nat over Counter if on put�llc;roadways::needsRC3W , y�{ " �_ ` • � ' �
<br /> � . -• ': ,, . , ;.r,. .�
<br /> s ,'.i;".,,:� --, , . _ ��, ,., ,. --� . . > .. -- -... . � . -:.
<br /> '...�..,� ,.......,,.� ., ,_._. _�•_-_ _ a. ...:: .�Y.,.��
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