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8� (aao-oo2o Ci of Zephyrhilis Permit Application Fax 813•�eo-aoz�
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<br /> Buitding Department
<br /> Date Rec�tv d � ' � , � ` _ �
<br /> �� -Phon�-Goritact�for Perrinittin" �':�� 1 ' �a b
<br /> C3wner's Na e �'! +�S L�c�` . . 5 Qwrnsr�hcne�iumber C3 t�'� J�7-'����, .
<br /> Owner'sAd res$ � �C7��-` t`� /`'t'L�ei ' QwnerPhone-Number � �
<br /> F�e Slmple Itleholder;Name'' � ;�" ` � �_ OwnerPhone Number =� _-� � "
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<br /> Fee Sim !e�Rleholder.Addr�ss � � � + L� ^ . . . '
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<br /> JOB ADDR�SS � � D , 6 ,�'- . . LOT# .. �
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<br /> SUBDIVISI�Pl ��77�Q /�QT!`�'E��. '-PARCEL'ID# � ` �c�'-.c�/'.-Ga-, �L� 4� �- l`�.�'�
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<br /> WORK PR PQSED ';. NEVv�CONSTR•: ; ADp/ALT " C�� SIGN [� ' ' CJ,.. :,DEMOLISW� - ..
<br /> - .,-� e _> INSTALt .�' �REPAIR= , . .
<br /> PROPO,S`iE �USE� ,Q` �SFR ' �' °GOMM'� �] ''QTHER ; "' . : . � .
<br /> TYPE O�C NSTRUCTION. 'Q` ''B�OGK`' �Q",, ,:"FRAME, � STEEL ��- - � �
<br /> DE3CRIPTI W OF WCMftK ` � /l�s G' � . rt " �. ll.� / _ i� ��-' C0� d� ,
<br /> BUILDING 17,E�`'� � ��34<�OOTAGE. MEIGHT�� -
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<br /> �;��Fi.;>r:.t.. :r;,,.�.n�Fr'........:-,_ - . . . , '
<br /> Q UILDING $ `;VALUATION`�F"�TOTAL'CONSTRUCTION' .
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<br /> Q LECTRiCAI. � �} �'AMP SERVECE Q` PROGRESS ENERGY �.�_ �W.R.E.C.
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<br /> Q LUMBINt� $ . .
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<br /> [„� ECHANIGAI. - $ `l3�y�/ ,�,j VAlUATt�N;QF MECHANICAL:tNSTALLATION � -
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<br /> Q S �Q.. - RC}OFING;4,;=Q SPEGIAL'iY�_� OTFIfR �
<br /> FIfU1SHED LOQR EI.EVATIONS ��� F1.00D ZONE AREA [�YES. NO >
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<br /> BUILDER COMPANY " �
<br /> SIGNATU E REGIS7ERED . Y/ N, FEE CURREA'. Y L.N_:�: . -
<br /> Addr ss � _ ' � � �Ucense#'�� � �
<br /> ELECTWC API;�..-. ,_ � . , ,,"`CONIPANY ' , . - `,_ . . ��
<br /> SlGW�TU E - "' REGI$7ERED Y/ N F�suitr�n Y/N''
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<br /> Addr ss . � � ' , -.License#�.=�t�-`� A ' ��
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<br /> PLUMBE � p � COMPANYY: �• ' ' . .. -
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<br /> SIGNATU E:;x Y - • - ..; :REOIS.TERED�' : z,.:: ;:.-Y'/-.N. - • .FEE:CURREk.` '< Y/'N: '
<br /> Add ss �:, , x � , Ucense#•,�,^ . . �
<br /> {NECH�0.N1 AL:'�` ` � �� , _ .COMPJ4PIY,; ��� y t�f2 u`'�- . A��C�.�'� G°%, .
<br /> SIGYVATU E '�'' ���'"� 2���Q�7L(+�,_�•. . , �REGISTERED'; , , .Y:l'N' ..FEECURRE��' . '�Y:/MIV`�:� _ " ,
<br /> Add s�' ' �'7� % �N` /`�f 4'/� L-LS� : ,. ..:License# �.�,�Tt��- w`, � .�.
<br /> OTHER _ _ _.� ;a . _._:} . ..-. - - �COMPANY , - .. ' -, -, _ , .,. .
<br /> SIGW14TU E - ' `':. " �°' . . . . . y,REGISTERED Y/ N-.:' FE�'QURREp, �YJ,I!1-_ ? -- ' .
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<br /> � - �f=� ildin �P..laiis�:�1 ;seti'af�Erie �Foriris�-R=O-W;Peniilt;for�neyr„construction;: >
<br /> R SID�NTIAL'�, _�A� r.t�?:(2):,PIot;Pians�}2. sets o B�u 9 �_(.). !�8Y . .x„ .,,. ,,. N.�.,,,;
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<br /> <s �Mlnimumt,ten�s10:�wor'itin xcla s;at#er,:suamittal�daEe*Required onsite;�`GanstiucBon�Plans;}Sto`rinwater.Plans wL�SIIt FenC,e;installed,. t
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<br /> � �Sanitary�Fac�4l��si:8���gi�u't�psfer;Sitei:VliocicaPe�rtnitX�r.subd�ql`slbnsitarge:piojecis' ��j.�• � " •„ ;
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<br /> C.OMME CIAL Attach(3��i�o�nple't�i"sstis'aa�B'�tl'di�tg`Piarss p�us a'I:Ife Safety�Page:(1)seg of Ettergy Forms.i2-t)-W Permit far new-constiut�tton:
<br /> . Minimum te�(10)wrorking dayg after submittal date. Requfred onsite,,C�nstrucUan Plans,Stormwater Plans w/Sllt Fence installed,
<br /> Santtary,Facil�tes:.�1 dumpsier._SIte�Woric Perntit far,ai{neiiv�pi�iimject's:`A41 commerclai�qulrements�mu�st meet compitance � . .
<br /> $IGN:PE IT Attacti"(2)sets of�ngineeir,ed�P1aRS� s r- _ .' �
<br /> •"""PROPERTY,S.URI/�Y requlrerJ br aJl NEW conshuati,on � _
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<br /> 'Qiiectlon .��;::;= - , ' ' �- - - _ - _�. __ _
<br /> Eitl o t eppticaUon completely.
<br /> Own r 8�Cootractar stgn.:back of.appltcaUon,natarized
<br /> I�ov r$�SOO.,�Notice,of:Commencement is require�l. (AIC upgrades_over 5T5pQ),. _ � �-
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<br /> Age t(#ortne contractar}`or:Poi�iec'of P�ttoiney(f(i�#tie�owner)woutd be someone pwith,notacized letter from owner sutho�izing same
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<br /> 'DVER� E COUNT�R:P.ERMITIING-�=".. .=(Front=6f�Ap'plication`Only)'..
<br /> Reroisfs-i sh{ngies Sewers ServicaUpgrades.A/C F_Fences,(Pl,ot/Survey/Foatage) ��- �-
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<br /> L1rlv ways-Not over Gounter if on public roadways`..needs ROW
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