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<br /> �13-780-0020 City of Zephyrhi!!s Permit Application '` Fax-�B -0029
<br /> Buiiding Department \
<br /> Uate Rec fived r-- �--f� phane Contact for Permi in ��� .� � — ✓ �
<br /> Owner's ame ��� � � Owne �C " J �
<br /> Owner's kddress � � t7 Owner Phone Nnmber�� �
<br /> Fee Simple Tltleholder Name Qwner Phone Numlaer� �
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<br /> Fee Stmp�e Titlehalder Address
<br /> JOB AbD ESS L��� ! � c�,i'���Z'�- I�� /L.f_.S �G.- .?�`�� � I.OT# �_`��L—1
<br /> � J / M VVM'��f/ �V
<br /> SUB�D{VISION �� ��.t'.,r, r�nc��.ir� /a? � 18'�-i .
<br /> {OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WflRK P OPOSEq NEW CONSTR AD ALT Q SI�N � MOVE Q DEMOLISH
<br /> e lNSTALL � REPA
<br /> PROPOS d USE � SFR � COMM �J OTHER
<br /> i1tP�OF ONSTf�UCT14Pi �' BLQGK 0 FRAME C] STEEL Q 07HER '
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<br /> DESGRlP !ON OF WORK �/�c..-/�SS� �7c./�� � ��
<br /> BUILDIN SIZE ��� SQ FOOTAGE�._._� HEIGHT ��
<br /> � B�«'Q��� � J f Q� �� VAI�UATION OF TOTAL CONSi'RUGTION
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<br /> [� El�EGFRtGA! {$ � AMP SEF2VIGE 0 PRQGRESS ENERGY Q W.R.E.0
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<br /> � [� PWMBING $ � /� i
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<br /> ? MEGNANlCAL $ VALUATION OF MEGHANICAL tNSTALLATION
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<br /> ;� Q GAS . �OOFWG � SPECIALTY Q 4THER
<br /> ,� FINISNE FLOOR ELEVATlQ 8 � FLOOD ZONE AREA QYES QNO � (� �J�" � tJ''�""
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<br /> ,� SIGNATURE i'G � y COMPANY ����7I�f (�� `
<br /> EGISTEREO Y I N FE CURRENT , Y I N
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<br /> ;! Add�ess �" � License# ����/,� �
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<br /> �� ELECTRI IAN ��(�` � CQMPANY ���:X..� �fE=��l�
<br /> �� Sl�NA7!!i E REGISTEREp Y/ N FEE CURRENT Y/N ,
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<br /> �� Add ess �� License# �/[����,,�,��, __1
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<br /> ;� PLUMBER COMPANY
<br /> j� ���''N'4�U � REGiSTERED Y/ N FEE CURRENT Y/N
<br /> ?� Add ess �i �
<br /> I! !� �icense#
<br /> �' MECHAN CAL � (� „ CQMPANY
<br /> i ! SlGNATU E ftEGlS7EEiEp Y I N FEE GURRENT Y/'N
<br /> - Addr'ess Lfcense# �` - �
<br /> �TN�R � COMPANY
<br /> SIGNATUFZE � REGIS7EREQ Y/ N FEE GURRENT Y!N
<br /> Add�eSS LlcenSe#
<br /> RESlDENj IAL Attach{2)Plot Plans;(2)sets of Building Plans;{1)set of Energy Forms �
<br /> Minimum ten(14j working days after submiktal date. Required onsite,Const�uctfon Plans,Sanikary Facllities$�1 dumpster
<br /> ' CQMMER,GlAL Attach(3j sets of Building Plans;(1)set of Energy Forms.
<br /> � Minimum ten{10)ryorking days after submitta!date. Requirgd nnslte,GonsWction P1ans,Sanitary Factli8es&1 dumpster
<br /> } Aif cammerciai requirements must rneet campltance.
<br /> SiGN PERM)T Attach(2)sets of Engineered Piarrs.
<br /> "*'PROPERTY SURVEY requlred Po�a(1 NEW constn�cfian.
<br /> direction ; - - 4
<br /> Fill o�t appiicatian compieteiy. , �
<br /> Own r 8 ContraEtor sign back of appiication,notarized � �
<br /> If o�r r$2540,a Nofice of Commencemenf Is required, (A1C upgrades over$588U) _ - �
<br /> ""� Ager�t{for the contracfor)or Power,of Attomey(fo�ihe awner}would be someone with natarized letter from owner authorizing same�;:,;.;,,
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<br /> OVER TF�E COUNTER PERM17?iNG��� '(Eront of ApplicaGon Onlyj;� ��- ="='�'��== :. -
<br /> ,=�F�:�.<-�-.::-.. "i
<br /> Reraofs Sewers Service Upgrades A/C,� '_ Driveways Fences(PtotlSurvey/Footage��f:u��-,�y;,;w>;;��
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