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<br /> 813aeo-oozo City of Zephyrhilis Permit Application Fax 613-7aaoo2�
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<br /> f Build�ng Deparkment ' '
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<br /> Da#e Recelved .�'�r�,(���� - Fhoe�e-Contact for Permittin <_ - � �
<br /> 4wner'a Name /�F c�a.c�- �tWtS�c��..1 Owner Phot►s Number �7$ " �''�Z"2 3 2?
<br /> Owner`s Address �.,03�d ��¢r�Pu.r�cac�.. �C': � rk1�5 S"'Y'LOwner Phone Number �— �
<br /> Fee 3lmple TI eholder Name �� - � `Owner Phone Number '�— �
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<br /> Fee Simple TII eholde,r Addr,ess °'
<br /> JQS�I,GDRES3 �O 3 OGl 3rQ,�.��,.,�r,Z, +."7r. �+y�ti1:��g,� I�G-� 3�J y Z LOT# C� {
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<br /> suso�visiob. S:t�cr c�.�.3- P�w�,O PARCEI.ID# C�3-�40-21-o��e,�.-avc,00 - d g,�c.� . �
<br /> � . (OBTAINED FROM PROPERTYTAX NOTICE)� i
<br /> WORK PROROSgD '^NEW CONSTR •." - ADDiALT [`�' " SIGN" Q Q DEMOLiSH i
<br /> • e� • INSTALL � ;, REPAIR . - i
<br /> PRQPQSED�USf Q SFR � `[� COMM'� � OTHER ;
<br /> TYPE OF CO�ST.RUCTION��� Q � BLOCK � FRAME C� STEEL `Q �
<br /> DESGRIPTIQ�N OF WORK ��� x^�E�d�r' �oF� I.v� c�o�, :r.s; ' i
<br /> I - , �R.. QX�s�'iv► 2 V d' QI(i��,CaS: i
<br /> I + N t r� - r j! M ya i ++�"�, Qxe�y�i
<br /> BUILDING SIZE ° �y y K �'y � SQFOOTAGE ./O�''4 HEIGHT.. f� u S c� � �
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<br /> QBCiI�DING $ VALUATION UF TOTAL CONSTRUG710N �
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<br /> QELECTRiCAi: � � AMP SERVICE Z� ' n PRt3GRESS ENERGY Q W.Ft.E.C. ;
<br /> '�/7UCa;' WGa��My avru�e_._. ;
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<br /> QPi:UMBING $ ^� .
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<br /> MECHANICA� V,+�l "� ��
<br /> � i � UATlON CiF MECHANIGAI INSTAILATIfJN `��� t��
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<br /> ��� . [� aooF�s�� 0 s�Eci�.rr-� o�E�. ; �
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<br /> FINISMED F400R ELEVATIONS FLOOD ZONE AREA QYES (I�D
<br /> St,7�%,��'i.ti .
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<br /> BUtLDER " �3,� �COMPANY �•.�+►s �,, �v�l:a.e,r ,3.�rfi,,,, �
<br /> SIGNATURE ReGISTEtte� Y/ N FEE CURREK Y/N !
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<br /> Addre$ �S'`$I S6 J� 301 ,'�,,o.G: .r1-�3��3 . � L"icense# C,BG. /2�"804�0 � �
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<br /> ELECTRiCU�I OMPANY =� �c�c`�+%� +�le.c,�'r:t,;. ,i,,�. �
<br /> SIGNATURE i' ^ REGISTERED Y/ N FEE CURRE� 'Y/N I
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<br /> Addres� X . ct�,.. �-L 33 2�.P- , , ` _ucense#.; s��t 3 t���3 g 3 � 'd�°
<br /> PLIIMBER —' OMP<ANY • • ��. �i w �2 "`�i
<br /> ,�' � � � 4 .� .tr. v�t*►„:��. o�'r �{nr'.c�e.. Ll.�., �
<br /> SIGNAI'URE � _ REGIS7ERED Y L:, FEE,cuwten. - Y/N ;
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<br /> Addre� Y N� r3 � cs7 r��o r � ucense#� �F�. -�5"7cS'/� __�, �i
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<br /> MECHANtCAI. ��LIMPAMY: , (Y�{y r �
<br /> 'SIGN R � � .` y ' ,
<br /> ATU E� � "�" ._ ftEG18TEREp 4' .`�.{ FEE RRE� Y/N .
<br /> ��ldr�� o'�$�'.� � ;� Pr� L(cense# C�+►�iGl�y�� ��
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<br /> OTH�R �I � , • ,. CQMPANY.; :� � �
<br /> SIGNATUREi�'� " ' �- � ' `' �' ` REGI57ERED Y/ N__. ,FEE.CURRE� Y/N . , �
<br /> Addrs� -- - -� - � , �� Ltcense# �
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<br /> - RESI0ENT1 `'; `r SAttach(2};Rtot�.Ptans;..(2},;sets�of�Bu[!i!i'ng"Plans;?(1}''sei of Energy�Forms;`R=0-W`Permit fornew i�nstn»cfion, ,�.`��
<br /> Mlnimum�ten;(,1,p)�,working days;after�sub'inittal:date:::Rqiqulred.ansite;ConstrticNon=Plans;Stormwater'Plans w/Siit Fence fnskalled,
<br /> �'. '�Sanitary Eac{i4tiess&=1:=clumpster�,Slte'.Watfc;Permit<for-�sutidiVistonsAarge>prbJects �•� � - _
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<br /> COMMERC i Attach(3)'oomplete�seb'"ofBuittling£Plans�plus a life 9afety Page;'(1�)set of Energy Fotms.R-C3-W Permit for new:canstreicHan. i
<br /> Minimum ten(10),warking days after submit�l date. Requfred onsite,ConsWctlon Plans,Stormwater Plans w/Sflt Fence insfalled,
<br /> , Sanitary Facliltles�1 dumpster.Site Vltark Perinit for ai!new'prnjects:Ati�commerclat�equicements must meet comp!lance
<br /> StGN'PERM�T At#acti"(2)'sets of Engineered•Plans.:;�m4:,:;,._.'�- ",<�:. � , , • ' . -
<br /> "'"`PROPERTY SUR1/EY reguired for all,IVEW,construction.
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<br /> Directions: j • .. � - .. . , .
<br /> Fill out applicatlon completely.
<br /> thvnsr�Cantrac�r s�gn back of appllcaUon.notariz�i
<br /> if ovar$a2500,a Notice,af.Commencement i$requirad. (A/C upgrades over 57900)
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<br /> '• Agent{for the�coritiaotor)'or'Pdsnier`ofiAttomey(for#tie�owner}would be�sameone wifh�notarized letter from awner authorizing same
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<br /> D,V.ER THE�OUNTER.P.ERMIT7ING�-�--• (Front of�Apptication�Oniy)��
<br /> Reroofs if shingies Sewers� Service Upgrades A/C Fences(i'lot/Survey/Footage),...,,,;,,
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<br /> privevrays-Not over Counter if on public roadways..needs ROW ' ';"-��j:�`' ' ' } ,„ ' ,
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