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�' s��-�ao-ooao City of Zephyrhiits Permit Appiication Fax-813aeaaaz� <br /> • Building Depa�nent <br /> DateReceived " phone�Cantact•forPermittin � � V� - O�� <br /> Owner'a Name 1,.�.� � t_.J Qwner Phons Number <br /> Owner's Addre�s "t � ��• r �Owner Phone Plumber � � <br /> Fee Slmple 7ltiehatder Nanse Owner Phane Atarrrber � � <br /> Fee Simpt�Titleholder Address <br /> JOB ADDRE�3 GJ 1 �1 W� y �- �{�7# � <br /> SUBDIVISION ����f��V�l„� �� PARCEI,ID�k V"!^ " '- " �V""l� <br /> (OBTAINED FROeA PROPERTYTAX N0110E) <br /> WORK PROFOSEd NEW CONS7R' ADD/�4LT [�' SI(3N Q [� DEMOLISH <br /> � INSTFiIl. REP'AIR <br /> PROPQSED>USE Q SFR Q COMNt � OTHER <br /> rrPe oF cos�srRucno�a �Q a�oc�c ; C] F�� [� s�e� � <br /> � �/� 1 . <br /> DESCRIP"TIOPI OF WIORK Y Y O! � 1����L.�1 <br /> Bt�ILD1idG SiZE SGl FOOTAGE[� HEIGHT ��� <br /> OB���'����' �� VALUATION`CIF TOTAL COiySTFtUCTION <br /> .J • I <br /> QEl.ECTRtGAI $ ' AMP SERVlCE Q PRtJGRESS ENERGY � W.R.E.C. <br /> [,�PLUMBlf�tG . $ � •1 . � " <br /> o� <br /> QMECHANlCAL $ VALURTlON dF MECNA4+tiCf1L EidSTALLATlOi�i <br /> ���.. <br /> [�G,4S Q ROOFING .(� SPEGAl.N � QTHER <br /> FIMISHEQ FLOQR Et.EVATIOPlS ��� f�OQD�t�1�lE AREA QYES. NO <br /> 8UlLDE1� CBMPANY <br /> SIGMATURE REG�ST�REo Y! P! �E cuRE� Y I R! <br /> Address - Llcense# ��` I <br /> � � <br /> ELECTf�iC1At+l� COMPANY <br /> SlGMATUItE � RE�ts'rERE� Y t N �CURt�ti ' ' `Y!N <br /> Alddress License# f i � I <br /> PLtlMBER � —._..� COMPAt+�Y ' <br /> SIGfdA'TURE REGlSTERED Y.l.-N, �Ct�� Y-/N � <br /> _ � � <br /> Addf+�S� � LiCense# � ' <br /> BIiEGlfA�+lICAi: � CfJMPAt�tY <br /> SIGPIATURE REGtSTeitEn Y./ �+! . . FeE CURREn . . Y t=�) <br /> Addres� ' � � ` License# 1 ��� <br /> OTHEE2 .COMPAl+IY ., �. . �� <br /> $IGNATU�E � REGISTERED Y/ . FEE GUt2RER Y . <br /> ..... - <br /> .. _ <br /> Address "t�c� �.�'�',� - � '� Licerise#� �� "l1"� � <br /> . ......:... .. .�.,., ..,.. , , ,�. . : . <br /> . .,_..._ ..�,,, �.� , . . . <br /> RESlDEN�TIAt.;;� Atkaclr(2)�i?l6f.Plans;{2}'sels:of=Bitilding�Rlatts;{1}seti of-Eriergy;Foims;R=4W Pertrtlt fcr rcew coitstruction, <br /> • • � Minimum:ten,(10)�working days.after;subrinlftalilate:�Requireii onsite;Consfructlan'Plans,Stonnwater'Plans wl SIIt Fenca lnstalled, <br /> � ` �Sanitary Facilittes,&:9�;dympster;Site:Work;,Pe[mit#or subdiWsjonsliarge pro)ects„._..,:_�� � ' r ` <br /> CQIi!lAl1ERC1RL Attach(3}comptetei'sefs of Balttling"'Plans plus a tlfe Safety Page;{1}set of Energy Fatms.R-O-W F'ermtt fttr newt const�vvc�lan. <br /> Minimum ten(10)working days afker submlttal date. Requlred onsite,Canstruc8on Plans,Stonnwater Plans w/SIlt Fenc�lnstalled. <br /> Sanitary Fadlitles 81 dumpster.Site Work Permit for ali new projects.All commercial requlremenis.must meet campliance <br /> 5i�t�PERMlT Attada'(2j sets af Engl'neered=Plans� -� <br /> ""PROPERTY SURI/EY required for al!NEW canstructlon._ _ <br /> Dlrec4lons: - . , <br /> FtU out applicaBon completety. <br /> Owner�Contractor sign back of applicallon,notarized , <br /> tE over+2500,a Nattce af Commsncemen#is required. (fUC upgrades aver S7S00) <br /> " Agent{far the cantradorj or`Power of Attomay(for tlie owner)wautd be someone with notanjzed tetter from owner authorizing same <br /> 3VER TFiE COUNTER PERMiT'iiNG .�tFron#af�AppUcation Oniy) <br /> Zeroofs[f shingles Sewers Service Upgrades A!C Fenc�s{PicttSurvey/Footagej <br /> Drivewaya-R2at over Counter if on pubiic roaduvays..needs Rt3W <br /> - <br />