|
. - �,�-r�o-vozo Gi#y of Zephyrhlls Permit Application Fax s�a-7saaaz� , ,I
<br /> Building Departrnent . '� �
<br /> ., - �
<br /> ( �
<br /> Date Recelved _ .. phone>Gontact for Parmtttln - ��3 �c��'— �Q� �
<br /> �l��� � �s / �;
<br /> Owner'a Name �T"�L�'�» Owner Phone Number ol�-��(�"' �0�� �
<br /> :�
<br />, Owne�'s Addres� �� �` ���� ��J�j•�LS ���3 Owner Phone Number� � � �t
<br /> Fee Simpte Titteholder Narne �^ � Owne�Phons Namb�r i � �
<br /> �
<br /> . i
<br /> 3
<br /> Ferr�Stmpte Tittehotder Address p;
<br /> �'
<br /> aoe aoaR�ss .5f� `�•�� zoz� C_� �
<br /> s
<br /> �
<br /> su�oivis�a� � � P;�c��..�o� �/� �� �1 C�l� /�c��l� G��'c� �
<br /> , (OB,7AINED FROM PROPERTY TAX HOTICEj �
<br /> WORK PFtOPOSED ,:NEW CONSTR' RDD/ALT �Q` SIGN' Q Q - DEMOltSN i
<br /> �e,- INSTAI.L �•..REP'7?11R - i
<br /> PROPOSEDFUSE � :Q SFR. � GOMM Q �OTMER " �
<br /> TYPE OF COPlS'fRUG'IiOtd Q� ' BLOCK " Q FRAiME � �STEEI"' `Q �
<br /> j� x ;
<br /> DESCRIPTION OF WORK , ISL"�r �� f}'l� e" ` � 8J1f��� � J '
<br /> a
<br /> BUlLDINC3'SlZE `�—��1 SQ EOOTAGE:' . - ,HEIGNT y����� <
<br /> p
<br /> . .
<br /> ,,,,.
<br /> , ,. ;... _ s
<br /> 08UILDING $ VAl.l1ATtON�OF 1°t?TAL COtriSTRtJCT10N- k
<br /> : • �
<br /> _ �
<br /> QELECTRICAL �� AMP SERVICE Q � PROGRESS ENERGY [� W.R.E.C. 1
<br /> . i
<br /> `QPLUMBING -r��---�� ' �
<br /> �. �
<br /> QMECHANIGAL $ VAI.UATION OF MECHANICAL INSTAL6ATION a
<br /> �� �� - i
<br /> ,
<br /> QGAS Q ROQFING Q SPECIALTY'Q OTHER
<br /> ,
<br /> FIAi1SHED fLOOR EIEVATIONS �fff y 1� FIOOD ZONE AREA QYES. NC? �
<br /> >
<br /> , . _ _ �
<br /> � BUILDER COMPANY'` - i
<br /> � SIGNATURE RE�iS;�R�n Y 1 N . -:�E cu��h Y7 N
<br /> Address ' - �icens�# �� �� �
<br /> . _ � , ' !
<br /> , ELECTRICIAN 4. `::COMPANY �
<br /> � SIGNATI.NZE � REGlSSERED Y I �1 FEE CClRRE�:�- �:;Y 1 CV ;
<br /> ' �'"'"'� �'� i
<br /> Addre�ss � , , Llcense#.�__ rt ' i i
<br /> PLUMBER ` , COMP:.ANY . �.
<br /> S1G{VATURE' . ' � REGlS.TERED, - Y.l�N�; -.�EEGURREE� Y-1N
<br /> Addrass , ��.llcense.# � ��
<br /> MECNANICAL ' �..--� � � , COMP.AMY _ ��'�� � �/'V� �'%� � -
<br /> SlC3NATURE ' 1���� s�GisT�i�a., Y.l N ,- �E=GU�En., . Y.I IV .
<br /> Addre�s '7"'7� /'7! � � � � License# ����'T�-�1�' -�–�
<br /> 4THER "• ., , . ` �;COMP,A{VY � e
<br /> SlGNAT1JRE" , .. ' , . ` , . ., � FEEGISTEREQ' Y l.E� _ . _��ctirt�t�s� Y 7 N.
<br /> Address •�� .t; _ , ' ' License# � �
<br /> ,�ki�'e.'.,.:: ' F::'"-.,;rn:4 . .� . . _.,�., ,
<br /> RESIDENTIAIi;���:�;•Atta�cii"(�'I�Plot`,Plaris;;(2)set`s"':afiBullding�'Plans;`(�1)'setof�Energy'Fartn's;:R-O=VV"Pemiif for new conshucdan, '
<br /> Minimumiten�{1�}wor�i� '_ '�.{ � ,���_� �.,, ..,, ��
<br /> ,:;j:�;�,:..�_�n: . . ,.`;,, ya,. ,g5days�after;;sutiintEkai�d'ate:��Req"u[r`etlons{te,�:Con�ti`iic�on�Plans;•�Stormwater`PlanswlSf{#�Fenceinstailea,
<br /> � SanitaryFacilitles�&�1�dumpster•�Site��Work:;Pem�it#oc�.sutidiyislonsAaige=pr!ujscts::���'=;;��� , . � � '
<br /> COMMERCIAL Attach 3�oom�lete"sets�of"Buildfn"°Plans''"lus a'GfeyS'afe Pa e; 1 set of Ene Forms.R-O-W Permit for new construction.
<br /> ( ) p 9 p tY 9 � ) r9Y --
<br /> �1t11t11tltUtit�8fl�'I O�WOPIdRQ da}t�8ft8t SUali11�8I d8t@. Required anslte,Cons#cuctian Plans,Stonnwater Pians wl Siit Fencs tnstatied,
<br /> Sanitary FadilUes&1 dumpster.Site Work Permit far ali new,-proJ�cts:Ali commercial requinements,must_meet compliance �
<br /> 31GNPERMl7 AttacYi'(2jsetsof�Engineered�Plans:U�:-;-�:-,� ,� , ..- � � �
<br /> •�::PROPERTY SURVEY required for ail,NEW conshucticn.. . •
<br /> Dlrectlon�: - � - , , __ � . �
<br /> Fili out aPpilcatioa cotnpletely.
<br /> Owner&Cantractor sign back of applicatlon,notarized � '
<br /> If ovar 52500.a Notice,of Commencement Is requlred. (AIC upgrade�c over$7500) •
<br /> �•�.;,:;�,,�,�..a�,;:�
<br /> '* l�gent(for the contractar)os Pawer`of`Aittomey(for ttie cwner}would tse someone with notarized letter from ovmer authoriztng same
<br /> DVER THE COUNTER:PERMITfING•-- �.- (Front of•AppllceBon�Only)-� � �
<br /> Reroofs tf shingles Sewers Service Upgrades AlC Fences{PtattSurveylFootage} .
<br /> .. .�.:':�. ... -a. - ,_:.'.s4..:" {_...e. �:F�.,t��
<br /> Drivawayte-NotoverCounter'If'on'public:ia`adways:needs�ROW ��,_ -• ': u ,`"' _ �' ""
<br /> 1 ,. . t � � _.t'�:J+. ,: r.. . .:�5': . -
<br /> . . ` . — ,. " — �t' �" '� ��F:},t'—:;'.,`u: ...e'z"t �,Ir't?
<br /> _ .,.�.. , . � ; �r.j.;.i?3i.... .- , �'{i' ' -
<br /> �" ly.,. .}._,o `�i'b1'c`� '
<br /> -� . ..� ... .. ' ' ' " . ..,_i'�5;p' .. .... . .. '� ._,t
<br /> ; . ,: .. � �' . . ,. � _ _. :.-,- ..+ ,.. �e:�z;...�_.":.,
<br /> ,f. , ' �.,. � `c s .... :p; ;etw;:v , +�;.
<br /> '�.„+..,a..Y.-.....r...,v.V.+.�.-,.�...,.�a..w�..vw....-.o..�.W«W..a.p.a...» .r. .w..» - ' ' ,..�.,,,,. _ .
<br />
|