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s�a-�sa-oaao City of ZephyrhiHs Permit Application F�-���-�so-ao2T
<br /> . , Building Department
<br /> Date Received phone Contact for Permitting � -
<br /> Owner"s Name �1-f��� -� /�.�. Owner Phane Number l� l� � 9����
<br /> Owner's Addrsss „J r�� ��G`�"����� J�� Owner Phane Number � �
<br /> Fee Simple Titleholder Name � � O�niner Phane Number � �
<br /> Fee Simpie 7ittefiolder Address
<br /> JOB ADDRESS , S�j"�� lOT# C_,�
<br /> su��ttv�stoN �fh��t1..RL� p�•z:��,'� r��zcE�.��
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WOR4C PROPQSED ,. iVEW CONSTR AQD'lALT � SiGN Q � Q DEM4LISH
<br /> e INSTALL. REPAIR
<br /> PROP,OSED USE Q SFR � COMM � QTHEf2
<br /> TYPE'OF CONSTRUC770N Q BLOCK •� Q FRAME � STEEL Q �
<br /> , �
<br /> DESCRIPTIOtd OF WORK � �
<br /> BUI�:DING'SIZE � � SQ FOQTAGE NEIGN'f -
<br /> '`BUiGDiNG � �5��� VALi1AT10N�OF TOTAL CGINSTRt7CT10N
<br /> Q�l.ECTRICAL (�> � AMP SERVlCE [� PROGRESS ENERGY [� W.E2.E.C.
<br /> „ L
<br /> QPLUMSWG � � �
<br /> � ���
<br /> QMECHANIGAL $ VALUATION OF MECHANlCAL INSTALLATtQN �
<br /> QGAS Q ROOFIlVG Q �PECIA�TY � QTHER
<br /> FINISHED FLOOR ELEVATIONS ��� � FLOOD ZON QYES NO
<br /> C ._. .
<br /> 8t11�DER � � G MPAtdY l��"�`���
<br /> SIGMATURE REGI9TERED Y`/ N FEE CURRE� Y/N.
<br /> Address - `License# �— �
<br /> ELEGTF2i,G1Atd ., ��.� • COMRAHY J`e �iz"c�c�,,,. �
<br /> SIGNATURE REGISTERED Y/ N 'Fee cu�tRe� Y/N.
<br /> , Addrsss ' . .License.# � „�
<br /> PLUMBEI2.,:: _ COMFANY-•• ' - � .
<br /> ,'SIGNA�TURE � • REGISTERED ; Y,•/ N. ', FEE CURRE� � Y/N .
<br /> ; �
<br /> Address ' License# �— � �
<br /> , . Y
<br /> _'.MECFIA1+1tCAE. - '' � CONIFAi�IY �
<br /> �''"SIGNA7URE`'` � ? +`- ' REGISTERED ; .Y/ N . , FEE.CURRE� - , Y/N � '� �
<br /> Add�ess�'° _ ' , ' ' , w ` , . Llcense.# � �.,'
<br /> �,a`ytF,;.. -� .., , . . , . . � � - , ,
<br /> �OTFiER�=.:,."'� _� .. • . ' ' �CQMPAf+lY -
<br /> "' SIGNATURE°3�-��_ - • � " � �t REGISTERED Y/ N. FEE CURREK Y/N �
<br /> � ,.�Address:: . .. . .�' ,�. . . Lic,ense# �� •�
<br /> =r�;i.�, - ., . .
<br /> • -, - : . � � < - -.�:; . . , -.. . . � .,. .. _ -
<br /> >:RESIDEN7IAL"H� :Attach;{2};P[at�Plans;;{2j�sefs�of'Building;Rlans;,',�1•)�set;of�Enetgy Forms;R=O-IN;Per[imit,for new.canstructlon;.. . - _" .
<br /> � � , '�_° �--
<br /> :��. _ _ . , , . . _- r.,.,='., ..
<br /> ��',,_, •��r-�.�.�`-��Minimum+:ten;'(;10)�wor'king�''days�after"s.utimittal�'ilate.'Required orisite;"Canstni'ctian.Flan's;S4ormu'vater Plans_w/Silt Fence�installed, -
<br /> ',".__:s.:s.. _ . _ � _ , - ,. ,. . ... . .
<br /> - - ',--- � Sanita,ry,,Faaitities;&�1�,dumpster;•Site;Woili:Permit-for;sutidiirisionsllarge°.p"rojeefs� . . - "- � �. - , � -
<br /> ,' , .}._. .; : y.
<br /> ��.�.GOMNtER6tAL" Attach{2}cor�iplete;sets af,.'Butlding.Placis.plus.a��ife:Safety Page;;{1)se#'of Energy.Fatms::R=O-W Permi#fo�neinr constnictian.: -
<br /> '"'�;:':=, � '' Minimum ten.(10)'workfng:days afte�submittal.8ate. Required on'site,,Cbnstruatian;Plans;�Stoimwaten Plans=wl Silt Fence installed,. , - ,
<br /> �r'=�'.� ��' : �� Sanitary Facilitles;&'1;duinpster.,sS(te.Work.P.errrr3t;;for%al.l-new,p'rojects.All.corrimercia!requirements.must,meei�comptiance
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<br /> ��. SIGN:PERMIT -.`�Aftach�{2}'se#s of Engineered Pians.�. �`� ` � :-` -,; :, . •
<br /> '•'�� •` ��: ' """"PROPERlY.SURVEY requi�ed:fo'r.aII,NEW constructlan:�. �j ••• � - �
<br /> �Directip�s: . � " '�:� , .<r^ ` ::�,a. . .'..�. .. ..... _ . .. , _ � .. ' . , - ' , , ..
<br /> ,. - _ �FIII�out appliqation.complefely:I"M '., .
<br /> � Qwner:&Contra�tor,s9gn lsack of�,application;'notariied.;. -,- � - °
<br /> -if oder,$2500;a Notice;of:Gommencement.is requirei3:,"(A/C upgrades:over$7500j- .,-
<br /> .u� "' 'Agent(fa�'fFie�contr'actor)'orPower•;of'Attamey�(foc�tFie:owner)would�tie�someone:with'notarizedletterftomownerauthoriiing.same
<br /> �. ..k i�r " �
<br /> '<;;OVER.'{'HE�COUNTER;PERM17'TING .:`' `:,{copy:_ofconfra�t-required)';'�;';'•.: ..: ��'. �;. ' _
<br /> ',;;,Reroofs if'shinglesr- ;,,,,:Sewers, -�;'Seniice:Upgratles;,A!C` `Fences(RIof/Survey/Footage)
<br /> . „°.'•.�.:-,., - � . . , .
<br /> , � , Drtveways=Not;oye�,Counter:if�onrpubiic,`roadways:.needs ROW:�- �. , �
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<br /> i ' ' ��t�' _ •� , �- , .. � ' .i , _ �.'.�$�.
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