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w, r.�8»-�eo-oQ2o City of Zephyr�iills Permit Application Fex-s�aaeaoo2�
<br /> ' � �' euitding Oepartment -
<br /> Date Recelved phanerContact tarPermlttEn . �/� t�� _��`�
<br /> Owner's Name ���' ���DGV - � ,. dwner Phone Plutrtber ����'~/�ol r l���
<br /> ,�} � ��� �� -
<br /> Owner's Address ����� �- �%/1,I �'TU�_ dwoer Phone Number
<br /> Fee Slmple 7ltleholder Name Owner Phane Number' �_ �
<br /> Fee Simple Titlehalder Address
<br /> J09 ADDRE3S ��J�� �/N��L�'G�E' /`�`V� LOT# ��
<br /> su�o�visioN � I���'IIoGt� �� PARCEL ID# l..�o'� �?�o �/ l?� _D DD�� DG�,?1�
<br /> , , (OBTAINED FROM.PROPERTYTAX NOTICE)
<br /> WOFtiC PROPOSED � HEw CONST� ADDIAI.T [� SIGN `C} ' [� DEMO�ISH
<br /> -e. �INSTAl,I. REPAIR
<br /> PROR03EC3>.USE • Q SFR. Q COMM' �� QTFiER
<br /> TYPE OF CQNSTRUCTION � Q' ' BLOCK ' L]' FRAME Q STEEI. Q �
<br /> �(, 1 ~'�. j�
<br /> DE3CRtPTIONOFWORK �`. � C G G�'—aLG"(� � v� jD41I /�l �G / � N,�{J�
<br /> . ,
<br /> BUIl.DING SIZE �� � SQ FOOTAGE,�� HEIGNT � ,� �
<br /> 0��l�d��C'' � � VALUATiOIV'dF1'�O'i'AL CONSTRI`lCTION
<br /> .�J
<br /> QEt,ECi'R1GAl ��� AMP SERVICE Q PROGFtESS ENERGY Q W.R.E.G.
<br /> QPLUMSlNG (�>—M� `
<br /> L
<br /> Q �� ly��� VAC.IlATtON OF MEGNANICA�INSTAICATIQN
<br /> MEGHANtCAL $
<br /> ,,,._,_, �
<br /> QGAS _ Q ROOFING Q SPECIAt�TY C� OTHER -
<br /> FINISHED FI.00R EI.EVATIONS ��� FLOOD ZONE AREA QYES NO
<br /> B!lII.DEit CQMPANY: ,
<br /> SIGNATURE RHGISTERED Y/ Pl FEE CURRE� Y/N
<br /> Address Ucense# �� �
<br /> � E�ECTRlC1RN: 'COMPAHY '
<br /> SIGNATURE ' REGISTERED Y/ N F.EE CURRE� � Y/N '
<br /> Addre88 , , . . , l.iGeitSe�#.( � J
<br /> , , , • . � ;.. . �
<br /> PI.UMBER .CQMPANY .,, . -
<br /> 31GNATURE' _ , ; REGISTERED. , Y/,.N., ; FEE CURRE� � . ". Y•/N.
<br /> Address � ' � i.icense# �1 .. I - • �.
<br /> � ,
<br /> M�cr�a�tca�: ' c, ctiMP�r ,�i4i-fR5 e ��� -.��
<br /> � .�tcm�.t"i'���'.� ,�.�_ , t��o :�� /�
<br /> SIGNATURE� ��isrERea .,_Y../ N. . .,,, �e Cu�. Y/�N
<br /> Addrsss� '`J'17�7'"f ��/�1�! ` a Z iyritL�'' 3�5�}l �ic.�nse#'I t�?-c=��.J�L�`�,�
<br /> OZNEtt ' , - ` ' ;GOMFANY �
<br /> SIGNATURE � � " ' ' 'ttEGfSTERED' Y/ N.. �e cuwtEn ' Y/N
<br /> Addre�as � . . � ,�^ . , _ Ucense# � �
<br /> ` - �� .. . _ ,.,...:, . . . ,.. ,. . ,.
<br /> REStDENTfAl;; Attach'{2);Plotf Plans;.(2}seis=of BuiEiling�Plans,'(1}seti of-Energp�Foiii�s;�Ft-0=W Pemi,it far new canstruc�on;
<br /> � � MinlmumGten;(,1,�Q);working}days;a�ter,:submiftat`date���Requlred onsite;Cansfrtictlon"Plans,Stormwater'Plans w/Sift Fence installed,
<br /> ' � `��"Sanitery Facilftl,es,&>1;,dumpsterrvSite�.WockgPermitfor,sutidivisionsAarge�proJects _ ;; ' � - - � �
<br /> COMMERCIAE. Attach(3j�ecmptete'sets'of-Bisltdl�g Piaris plus a Ufe`Safety Faga;'{1 j set af Ertergy Farms.R�-W PeRntt for new construction.-
<br /> Minimum ten(70)working days after submithal date. Requlred onsite,Canstructlon Plans,Stormwater Plans w/Sflt Fence installed,
<br /> Sanitary Facilides&1 dumpster.S[te Work Permit for all r►ew.proJects.,All commerctal requirements.must meet cempllance
<br /> SIGN PERMIT Attacti{2)"set�of Engineered;F?Ians:. •= �- . .
<br /> ""PROPERTY SUR1/EY required for aII,NEW,canstruCUon..,
<br /> Dlrectians: , . . . "
<br /> Ffll out applicaHan wmpletely.
<br /> Glwner&Contractor slgn back af appiicatlen,notarfzed
<br /> {f over�2500,a Nottce of Commsncement is required. (AlC upgrades ovee y7900)
<br /> _.,�.,;`���.�.,;,r3;r .... ,=.�, . .,n,.,.. :ri_..,..�..,_.... _ . .
<br /> " Agent(for ttie contraotor)or Power of Attomey�(fo�the:owner�j;would�be,someone with nota►ized letter fiom owner.autfiaNiing,same"' .
<br /> ;.; ,: „�,;.,. :, ; -
<br /> DVER THE COUNTER,PERMtT11NG {.. .(Froiit of�ApPllcatioii�t3nly)-,•� ;x '• � . , , -
<br /> Reroofs If shingles Sewers Service Upgrades""/�VC''• ��Fences;(RIoUSurvey/Foatage) � ' �� � . � .
<br /> Drivswaya-Not aver Caunter if on public roadways::needs R01N"� '''� .,w,� � � , .� f . , , ,` •� , , 'yr- -
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