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' e��-�aa�o City of Z�phyrhilfs P�rmit ApRlication Fm�es�Te�t�, <br /> ; 3ui�uog�eparb,rer�t <br /> Dato Rocofved Phono ContseQfor — � <br /> Ovmera Namo �� r � Orrt�er�Humbar O ���� I'�`J O� <br /> ownora aaareas � �� �`l55� �'(� aawr Rhom wumb.r <br /> Fmo Stmplo Titlehotder Namo � �fl����► � <br /> Fse Slmpb Titlehnider Addrosa <br /> JOBADDRESS v��aO �l�SSG� �Ir Zfi_ � Y��1"S � LOTf � <br /> � SUBDIVISIOM PA�EL iRN <br /> (osra�rRo11 aita�x�uc aar�cq <br /> WORK PROPOSED e NEW cANSTR 8 ADQlALT Q S1GN Q �Q DF.�AOIISH <br /> INSTALL REPAiR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTiON Q BLOCK Q FRAME Q STEEI Q <br /> oescwwnoNofwowc fl� Ci�c�r� av�' i►� See� �. �in S�� 1�+ C�l Spl�-F s�5 <br /> BIiILQlNG SIZE SQ FOOTAGE r�� MEICiNT [�—� . <br /> i QBUILD�WG � VALUATION OF TOTAL CONSTRl1CT10N <br /> � QELECTRICAL S AMP SERVICE Q PROGRESS ENERGY � VY.RE.C. <br /> QPLUMeING 3 , - <br /> f � " , <br /> o�CAECHANICAL s 3a�� VALUATlONOF4RECHANICALINSTAllAT10N ��I(/ � <br /> � ur � <br /> QGAS Q ROOFING Q SPECIAl.TY Q OTHER � <br /> FlPIISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES Pt0 <br /> BUILDER COWIPNdY � <br /> SILiNATURE n�o�s�x� Y/ �eURa�n X/.N' <br /> Addeass Lloense! - <br /> ELECTRICIAN COAAPAAIY , <br /> SIGNATURE r+Ec�srar�o �{'/N �c�n Y!td , <br /> AddmsB ���� <br /> PLUMBER CORAPANY � <br /> SIGNATURE t�cisnx� Y! N �-cxrat�n Y f fd' <br /> I <br /> i Address uceTM�� <br /> raecHanucai. � coN+�a�v �1 -�2 Ch �li�' �1(-�t�=a�i c�,LLC ,I <br /> s��c�uanra� r�as� �N �au�, Y/Pl <br /> ama� 4b s�-c�e (Rcl 5� uo�s <br /> oTMFR coana�nnr _ _ <br /> g��p�� �c�sT�o Y/ N iEE cuRR�t� Y!N <br /> Address ��� <br /> 11119DII1111lIIIIIt11E1191111ii@It111191Alillllitlllllltlllititll !-1 <br /> RESIDEN7IAL Attach(2)Plot Ptans:(2)sets of Bullding Plans;(1)set of Enerpy Fartna;R-O-W Peardtia'namr�udlon. <br /> Minllnum te�(10)warfting days after submittel date. Req�red onsfte.Co�relrueUrni Plans:Shomavater P�ns w�S0!Fatce ir�e9ed, <br /> Sanitary Faolities&1 dumpster.Sile Wak PermH for s�bQn431onSflargC PrOJ¢� <br /> CpMN7ERGAL Attadi(2)complete sets of Building PFens plus e lSfo SaiCfy Pege:(1)set of El1�y FMItB.R-O-W P�s1Et(Or t1eW 0�1Bii�11. , <br /> kLntmum ten(f0)vaortdng days after submittel date. Requlred otfsits,COnSfttiWotl PiIIc47.StoRlfYAOCf Pl3li4 W!B�tFCt108.�RS�Ysd. <br /> Sanftery FadGUas&1 dumpster.Site W�k Petmit for a11 new projeds•A�1 eafimetdal tr�tdtemetds rtu�eft�a� - - <br /> SIGfiI PERflA1T AttaGi(2)sePs of Ertginaered Plerts. <br /> ""PROPERTY SURVEY req�dred fw all NEW const�udio�. - <br /> 1� Dlmctlon�: . <br /> Fip out epptiraUon completely � � <br /> , pump,r 8,Conlractor sign badc of applimtion,noter{zed <br /> ` It ovor 525�.e Notico of Comme�cemeM is required. (A!C upgradea avcu ST�) � <br /> " Agent(for the contradcr)w Power o(Attomey(for the mxne�j woufd be someone adPh t�ot�ed letlrr tiom avfmr twtlwtt�np sa�na <br /> OVER THE COUNTER 9ERMITTIMG (copy of caniraa r�u+red) <br /> Reroofs if shingtes Sewers Service Upgrades FVC Fertces(PbUSurvey/footage) i <br /> 1 Drivowayallot over Counter ff on pubfic roadwrays..needs ROW , <br /> i � <br />