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slaaaa-ooxo � City af Zephyrhiils Permit Apptica6an FaX-a�a7saaaoz� <br /> Buitding Departmeni <br /> Date Rscelvad �j� � j Photstr Contact for Pecm�tt[n �� - �{) <br /> '� <br /> , _Y..r..i_ _ <br /> Owners Name U�,. � Owner Phone Number �3' q" ZSp <br /> Owners Address �l � Owner Phone Mumber ��� <br /> Foa 3hnple'Sitleholdanr N�ma � � Oamer Pho�se Nam6er �—� <br /> Fee 3lmple Ti@eholder Rddrsas - <br /> JOB ADDRESS l�N[� �� t,i � �DTl� �� <br /> SU801VISIOF3 � 3 FARCELID# �Z�7�Zt�V ^�� � 1n�,,� <br /> (08'fAINED FROM PROPERTY TAX N0710E) /'J.l� <br /> YVORK PRQPOSED e NEW CONSTtt 8 ADD/Al.T Q SIGN � Q DEM4USH , ��" <br /> tNSTAtI REPAlR 1���� <br /> PROPOSEd USE Q SFR Q COMM Q OTHER � � <br /> TYPB OF CONSTRUC7IQN Q BIOCK Q FRM�E Q STEEL Q �, <br /> pESCRIPTION OF WqRK <br /> ��. � � �� <br /> BUtLDINGSIZE �� � SQF003AGE�� HElGHT �� �f�,� yy�'(� <br /> �l y.r ��,� <br /> QBUILDIMG $ �1-4��%/—I yALUATION OF TpTAI C4NSTRUCTIQN <br /> `�_1 ln��j <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C. ��'� <br /> QPIUMBtNG �..� <br /> �n��cHar��c,� s . vr�uranac�oF�aECNnri�ca�iNsruu�nor� �i�����,,y��d:C��t'� <br /> cnP�c•�`v�e,f� <br /> C]ca.s � ROOFING� SPEGIALTY � OTHEO ��� ,���� <br /> FINtStiEQ Fl.00R ELEVATlOtVS FCQOt7 ZONE AREA YES N{} � <br /> BUILDER GOMPANY <br /> SIGNATURE � � r�cis��a � �E cuaaen Y/N <br /> Address licezxe#( � <br /> ELECTRtClAN � � COMPANY ( � <br /> SIGNATUI2E REC�srEi�ti Y i H �CttRR� Y i S+t <br /> Addrsss License# <br /> PLUMBER COMPANY � � <br /> r��G�,�p'(�� REG�srERED Y! N FEE GIJRREn Y/N <br /> Atft1f688 L2C2Ti88#� � <br /> MECHANICAL � � COfiAPANY � � ---. <br /> SIGNATURE � REGtsiEReD Y!t3 FEeCtiRa�n Y t N <br /> t '� <br /> Addresa License� I � <br /> � � �� <br /> BTHER CO(�PANY �; <br /> $IGNATURE �. RE�I5TERED Y/ N �E CURiiEt. Y/N <br /> Addresa +�"'� License# �..� � <br /> IIIIIIIIIIIIIIIII � IIIIIIIIIIIIIIIIII / ilI1f11i1111t1ilitillittl / 111i <br /> RESID6N'IULL Attach{2)Plot Plans;(2)sets of Building Plans;(1)set of Ene�y Fortns;R-O-W Permii for new consWcUon, <br /> Mlnimum ten{3fl}workthg days after submittai date. Requfrcd onsiEe,Constrndton Plens,Sfo�mwater Plans w!Sil[Fence lrc3talled, <br /> Sanitary Fadlities S i dumpster,S�e Wurk Permii tor subdwlsiorrstlarge P+rojeds <br /> COMMERCIAL Aftach(2a complete sets af Buiidfrg Plans plus a Life SaFery Page;(7)set of Energy Fortns.R-O-W Perrnit for new Conswctlon. <br /> Minimum ten(10)tiwrking days after submiflal dale, Required onsite,Construdion Wans,StoRnwater plans w/Silt Fence i�talled, <br /> Sandary FeeOities&9 dumpster.9ite Work Permit far at�new projecEs.ASi cammereiei�equsrements must meet compEiarsce <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> � '""'PROPERTY SUftVEY cequired for all NEW com3truclion. <br /> Dlrectlons: - <br /> FIIt aut eppiicaGon cromptatery_ <br /> Owner 8 Coniredar sign badc of application,nMarized <br /> If over�2500,a Notice of Commertcement ia requlred. (A/C upgrades av6r;T500) <br /> '* Agent(for the contractor}or Pav+e�af Attomey{forlha owner}wontd be someor�e with notsrized Istter from owner authorfzirsg same <br /> OVER THE COUNTER PERMITTING (capy of contract required) <br /> Rerools ff shingles Sew�.+rs 6ervice Upgtades A/C Fences(PIot/Survey/Footage) <br /> Drivqways-Nqt over Caunter if on pubi'x roadways..neads ROW � <br /> � <br /> _ 1 <br />