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• � e��-�ao-aozo Ciiy of ZephyrF►ills Permit Application Fax$��-�8ao°2� <br /> Building DepertmeM <br /> oata Rece�eod Phone Contact tor PertnNHn' <br /> Owne�s Namo �n ��..r� Owner Pho�re Number <br /> Owners Address , 7' �� r Owner Phonz tdumber <br /> Fee Simple TiBeholder Name Ormeu Phone Numher <br /> Fca Slmple TitleholderAdtirasa � <br /> JOBADDRESS Qu1�(s� F��G.��O C.CJCOO(,.K LOTB � <br /> SUBDIVISION �) PARCELIDf1 r� �`�� `��`c�a�`1.J�C,�J� <br /> (OBTAINED FR069 PROPERfYTAX NOTiCE) <br /> WORK PROPOSED B NEW CONSTR 8 ADDlALT Q SIGN Q Q DEMOUSH <br /> IfVSTAIL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTIOM Q BLOGK Q FRAME Q STEEL � <br /> pESCRIPTION OF WORK �`l� j� QI—' � C- j <br /> BUILDING S� Sq FOOTAGE� HEiGHT �� <br /> �BUILDING $ H�'j�,/� VALUATIQNOFTOTALCONSTRUCTION <br /> /�AJL.J <br /> QELECIRICAL $ AMP SE{tVICE Q PROGRESS ENERGY Q W.REC. <br /> QPLUMBING $ �^ I �^ �� <br /> ��� I <br /> QMECHANICAL $ VALl1ATION OF MECHANIGAL INSTALCATION <br /> QGAS � ROOFING p sPEcu��rv� OTHER ����_ � <br /> FINISHED FL��R ELEVATI�NS FLOOD ZONE AREA QYES NO <br /> BUILDER COfiAPANY Y . <br /> SIGfdATU � r�cisreaeri Y/ N F�cuaa�n. Y!N <br /> Address � h- � License# � ' G <br /> ELECTRICIRN COMPANY <br /> SIGNATURE ReGlsrer�o Y! N �cuaRe� Y/N <br /> Rddress L(cense# <br /> PLU0.IBER Cp(V�ppNy <br /> SIGNATURE ���srenEv Y/IV r�ctmaEn Y/N <br /> Address License# <br /> MECHAMICAL COG9PANY <br /> SIGNATURE rt�cis�o Y/N �cuRaEn Y 1 N <br /> adaress ucer�se u <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N F¢cuaaFn Y/N <br /> Address License# <br /> 111111lI1 � 11A91E11t111iiB9111Y1EB110s@IllillillllLIB11lIA6111'1l1101 <br /> RES{�ENTiAL Attach(2)Plot Pla�;(2)seis of Building Plans;(1)set of Energy Forms;R-O-W Perinit for new corahuctlon, <br /> Minimum ten(10)�vorking days after submittal date. Required onsite,Gonstruction Plans,Stormwater Plans w/Sit Fence(nstaAed, <br /> Sanitary FadliBes&1 dumpsler,Site Work Pertnit fir subd'rvisions/ler�projects <br /> CORCtAERC1AL Atiach(2)camplete sets of Building Plans pius e Life Satety Page;(�)set of Energy Forms.R-O-W Permft for new construction. <br /> Minimum ten(10)working days aftersubmitlai date..Required oruite,Construclion Plans,Stortnwater Plans w!Slt F�ce Fnstalled, <br /> San(tary Facilities&1 dumpster.Site VUork Permit for aIl new proJects.All commerGal requirements must meet compfianca <br /> SIGA1 PEFt6RIi AHarh(2)sels of Engirteered Plans. <br /> ""PROPERTY SURVEY requirad for ali NE1N canstruction. <br /> DlrecUons-• ' �+1 e 1 1 � Q i 1 � i.l�&d." ' • 6t�d ��i.a ' . <br /> Fill aut application rnmpletaly. <br /> Owner&Conlractw sign hadc of appfiwlbn,nolarized <br /> If over$2500,a Notfce of Commencament is raqui�ed. (AIC upgrades over 57500) <br /> " /\gent((or the contractor)or Power of Attomey(far Ihe owrler)would 6e someone wifh notarized letter fr�n owner auihorizirg same <br /> OVER THE COUNTER PERf1AITTItdG (copy of contraG required) <br /> Reroofs if shingles Se�vers Service Upgrades A/C Fences(PIoUSurveylFootage) <br /> Driveways-Not over Counler it on pu6fic matlways..needs ROW I <br />