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ea�-�saoozo City of Zephyrhi!!s Permit Applieafian FaX-s1�-�ao-oa21 <br /> Building Department <br /> .. . . <br /> Date Received Phone GontactforPermittlng_f�'i'i"'o � <br /> "r-�"I7-1�Tf 1 , ',I�:���: <br /> Owner's Name n Owner Phone Num6er O� ''� "��/ <br /> Owner's Address � �� 7 Qwner phane Num6er r` � <br /> Fee Slmpta Tftlehalder Nama C `'` � Owner Fhone Number <br /> Fee Slmple TlUeholder Address �" <br /> J08 ADDRES5 5 33a � r�+��,S � L4T# � <br /> SUBDIVISION � � PARCELID# ���' 'Z�" O � <br /> (OBTAINED FROM PROPERTY7AX NOT�CEj <br /> WORK PRpPOSED e NEW CONSTR 8 ADDIALT � S[GN � Q DEMO�lSH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF COPlSTRllGTldF3 Q BI.00K Q FRAME � STEEI Q <br /> DESCRIP710N OF WORK �G 1 <br /> BUILDING SIZE ��� SQ FQOTAGE�� HEIGMT [_� <br /> QBUILDlNG �� VALUAT(4N OF TOTAL CONSTRUCTION <br /> �ELEC7RICAL �� AMP SERVICE � PROGRE5S ENERGY [^] W.R.E.C. <br /> �UMBING ($ —� � <br /> MECHANICAL $~`�Q (y VALUATION OF MEGHANICAL INSTALI.ATION � / � V � <br /> E 4 l <br /> QGAS Q ROOFING Q 3PECIA�TY 0 OT!-IER <br /> FINISHED FLOOR ELEVATIONS �� FLObD ZQNE AREA �YES NO <br /> HUILDER � � COMPANY �— '� <br /> SIGNATURE REGtSTEfiED Y 1 N FeE CURRE� Y t N <br /> Address L.icense#i i! � <br /> ELECTRICIAN ^� COMPANY ^� <br /> SIGNA7URE ���sTE�o Y t N Fes cuwz�n Y i N <br /> Addrass License# �i � <br /> PLUMBER � � COMPANY � <br /> SIGNATURE �a�sTE�o Y i N �Ee cuwxen Y!N <br /> Address i� License# �— � <br /> MECHANICAL / _ COM�ANY ��,Q�"T�-K')�""� �(��r)���_�� <br /> StGkA7URE i�•�"'`'`'' REGISTERED Y 1 N FEE CURFiEN Y J N <br /> Address '/�t License# {� <br /> OTHER � CpMPANY � <br /> SIGNATURE RE�isr�o Y 1 N FEE cuttr�N Y!N <br /> Address License# �— � <br /> 1 ! l111111111 ! ! I { iil ! ! IlI / It1iII ( ttl / I / I ! ! l11 / 1 / III1Ilit / I ! lltltllil <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding Plans;(1)set of Energy Fortns;R-O-W Permit for new constructlon, <br /> Minlmum ten{10)working days after submittat date. Required onsife,CanstrucGon Plans,Stormwater P(ans w/Sitt Fence instafled, <br /> Sanitary Facilities$1 dumpster;Site Work PermiC for subdivisionsAarge proJects <br /> C4MMSRGIAL Attach j2)complete se#s af 8uilding Pta�s ptus a life Safety Page;(1}set af Energy Forms.R-O-W Pertnit for new construciion. <br /> Minimum ten(10)working days aker submittal date. Required onsite,Construction Plans,Stormwatar Plans w!Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Pertnit for aIt new projects.AIt commerciat requirements must meet compliance <br /> SIGN PERMfI' Attach{2)sets of Engineered Plans. <br /> ""PROPER7Y SURVEY required for alI NEYV construction. <br /> Directions:• • <br /> Filt out application completely. <br /> Owner 8 ConVactor sign back of application,natarized <br /> tf over�2500,a Notice of Commencement!s raquEred. (AtC npgrades over 57500} <br /> •' Agent(for the contractar)or Power of Attomey(for the owner)would be someone with notarized letter from ovmer authorizing same <br /> OVER THE COUN7ER PERMffTING (copy of contract required) <br /> i2eroofs if shfngtes 5ewars Senrlce Upgrades AtC Fences(PloUSurvey7Foatage} <br /> Drtveways-tUot aver Counter if an publio roadways..�ceeds ROW <br />