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/ <br /> s�a-7eo-oo2o Cify of Z�phyrhilis Permi4 Application Fax$13-780-01121 <br /> Buiiding Qepartment <br /> Date Receiv�d �� - <br /> Phoae Con#act far Fermtttin - <br /> Owrn�r's Pdame Y Own�r Phon$Nnm6er <br /> Owner"s Address � �- ��S 5�• Ow�rer Phone Num�er �� -� <br /> Fee Slmpio 1'iki�hoider Name �! � �� Owoer Phona Number �� � , <br /> � <br /> Fee Stmple Tltleholder Addrwss <br /> .lOB dDDR�58 t ��� � LOY# �_�„�GL!._l <br /> suso�v���o� �� ���i��' {� wa�cE�.to# 0� - C��-c� �- �D -C7�ta0-0�'1�(7 <br /> (OBTAINED FROM PROPERTY7'AX NOTICE� <br /> MtORK�ROPOSED NEtNCON5fR Ai�DlAt.T � StG#� Q Q DEMOI»iSH <br /> INSTALL 8 REPAIR <br /> PROPOSED:69SE [� SF}2 Q GOMR� C'� fJTHER <br /> TYPE OF COIVSTRUCTfO� [� -BLOCK " [^] FRAME �] STEEL Q <br /> DESCF�IP�iCiPt OF WCiRK ��'1 �t-�� 1rl 1�1 `�t�, � � <br /> BUILDI1dG StZE SQ FOOTAGE�_�: N�fGHT [�� , <br /> Q BUl1.Ql1�G �� VAIUATtON{OF T'O�'I�L COiYSTRUGTiOPI <br /> QElECTRiCAI � � AMP SERVICE Q FROGRESS ENEFtGY Q W.R.�.C. <br /> QPLUMSlNa- $ .��V� `�� <br /> �� ���� <br /> �]MECliAMGAL $ YALUAT101d OF MECH�PtICAt t1�iSTAE.LATiQA! •jlj`► <br /> QGAS Q ROOF{NG _Q SPECIAtTY C� OTHER �� ��j <br /> FIIVISHED FLQOR ELEVATIOIVS FI.00D ZQfiIE AREA QYES NO <br /> 8t!lI.DEt� CO�iit�ANY . <br /> �jG��� REGIS7ERED Y/ N FEE CURRE� Y/PI <br /> Addre� Clcense# � � <br /> IELECTRi�if�fd C0�3PANY <br /> 51GN�►TURE '� REGISTERED Y/ N F�cuRRen Y/W <br /> Addr�s � license# � � � <br /> ��a�r�s�r� co�pa�r -� ��11 ��1 ��'{� <br /> 9IGiYA'9'UIZE REGISTERED Y/-.N. . �E cuRREn Y-/IV. . <br /> �dar�ss � { � � �`1'� ucense,# �..c�-C�"R c�c��1 �� <br /> 6YlECtf�ICAl: ' CONAPANY <br /> ��G��+��� REGISTERED .Y/ fV . - FEE CUFtREA . Y L lV <br /> Addr�s� ticanse# � � <br /> CtTH�R - COt19E�At+iY <br /> StG�IATt�i�E �ctSTEr�n Y 1 N.._ �ee curu�n Y/N <br /> �do�rass . Ltcerise# � � <br /> �ESlDE4�'i't�l: Attach(2)Plcit-Rtans;{2}sets-af Buitding�Plaiis;{1)set of Enetgy�Foiirns;R 0=W Pei�nit ior new canstntc#�oa, <br /> Nlinimum.ten(10}woricing days after"submittal date.�Requlred onsite;Coinsiruc8on°Plans,Sfortnwater Pians w/Silt Fence installed, <br /> Sanifary FaclltUes.&,1..dumpster Site Work,Permit forsubdivlsion"sparge.projects � ' <br /> COflHtY91�RClR�L A4tach�3)compiete sefs of Buitdicig Plaris pios a Ufe Safety Page;('!}set af Enargy Forms.[2 Q t�t Permtf for nevir conshucftpsi. <br /> Minimum ten(90}working days after submitfal date. Required onsite,ConsUuctlan Pians,Stormwater Plans w/Silt Fence Instailed, <br /> SaNtary Facl�iBes 81 dumpster.Site Worlt Permit for all newr projects.All commercial requlrements must meet compltance <br /> S1G�3 PEI�lT Attecti{2)sets of Englneer,ed-F?lans. „ <br /> "`"'PROPERIY SURVEY required for aii NEW canstruction. . <br /> �irec#tons: <br /> FtU out applicaUon compfetely. <br /> bwner 8�Cantractor sign back of appltcaUon,notatized • <br /> If over$25�4,a Flotice of Gomm�nc�rr�e»#[s�ec�uired. (AfC u�gr�de�av�r$Y500) <br /> "" Agent(for the contractor)or Pbwer of Attomey(for the owner)wauld be someone with notarized letter from owngr auYhorizing same <br /> DYER TNE�01JFI7'8R P�MI'iTiNCs _-{Front of APAIEcattan Only} <br /> ReroeFs if shingles Sewers Servlce Upgradas A/C Fer�ces(Plot/Survey/Footage) <br /> �rivawaya-�lot over Counter iF an pu61Ec roadurays..ne�l�ROW <br />