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s�a-7$o-oozo City af Zephyrhill� Pecmit Application Fax-8'l3-784-OQ21 <br /> � ' ` Ballding Departrneni <br /> Date td�celv�d �Phone Cont�ct far Parmtttin <br /> Owner's iVame Owner Phone Numbgr <br /> aw�ers�aaress Y 1..�� Owrner Phon�Number � � <br /> Fee Simpl�Tltteholder N�me Ow�er Phone Number � � <br /> F+ae Slmpl�TltlehofderAddress <br /> �o������$ ��� e ��� �flg� ��c� <br /> sua�iw�io�a � �.�.�� � ��zcE�.ia# ... — � — �Q�f(�-� C� �(� <br /> (08TAINED FRQM PRdPEtiTYTAX HO?10Ej <br /> M►ORK PROPOS�D , e NEw CONsrn 8 ADU/ALT [� SIGN 0 0 DEMOI:ISH <br /> INSTAl.L E2EPAIR <br /> , PROPOSE��USE Q SFR C,] GOMNii C� OTHEi2 <br /> TYP�OF GOiUSTitUCTtOF! [,� 8LOCK ' [� FRAME � BTEE� Q <br /> dE3CRl�►YIOW OF WORfi • \ ► lJ 4 <br /> BUILDtNG 512E SQ FOOTACiE��_�� HEIGHT �,� <br /> �$U�LpiN'C" �' , �w� VALUATION`OFTOTALCOPISI`RUCTION <br /> L. <br /> QEL.EG3RiCAl �� AMP SERViCE � [� PROGREBS ENERGY Q W.R,E.C. <br /> QPLUMBING $ ��.�� �- <br /> QMECNANICAI. [� fr...fi.�_ YALUATlON OF MECH1�lVlCAI INST,ql.LATION <br /> � <br /> �,�,JGAS Q ROOFIfdG �:C] SPEClAI,.TY � OTHER <br /> FItVISHED Fl.00R ElEVATtQNS FLOQD ZOt�4E AREA �YEB �tC? <br /> I ._ <br /> ! �UIF.f3ER �ONiP,�IP3Y <br /> SiGNAYUR� REGlSTEREb Y/ i�t FEE cuRREP Y t N <br /> �, ,�ddress Ltaense# �� �� <br /> ' �d.�GTitlCiAf� CON9PANY <br /> SIGNATURE � �GIstFR� Y! N f�Ctltt� 'Y 1�! <br /> AdcGress Ltcense# I � <br /> Pl.UMB�i� CO&lPAt�lt � If�( �"�I <br /> �IONAYUR� tiEGt�TEREO YJ.lV- . FEEGURREA td <br /> AcPdr�ss License# ��,�'lJ"I ��vl I <br /> i�9@CH,�flGAL COMPANY <br /> SIGPl�iTURB t���s�o Y./ N : �cuttt�+. . Y!N <br /> �ddr��s ' � License# I � � <br /> O'YHEl2 COM�t�NY . <br /> SIGtV�1TURE RE�IsiEtt�u Y! N___ �cu� Y/N <br /> AdcYress Ltcense#•� 1 <br /> R�S1D�Ni"�'l1Ai:.. .AtNaoh{2).Ptoi.P<tans;{2)sets:of BiifiBing�Ptans;{t)sst of Eriergy Foims:ft-0-iN Permlt for�sew construc�an, <br /> Minfmum:ten.(10).working days aftec_subrtitttal d�te. Required onsite,�C,�anstiticNon°Plans.5torniwater'Plans w/SIIt Fence instaAed, <br /> SanitaryFacilitias&.1;dumps#er{Stt�:WariePermitiarsubdi�iisiohsliarge.projects__. - � <br /> CORRA�EFiClAL Athach{3)comptete sets of BulldEag Ptans plus a Ufe Safety Page;{1}set at Energy Fossns.R-Q-W Fermit far�cew c�nstrui�lon. <br /> Mlnimum ten(10)working days after�ubmttta!date. Requitsd onslte,Canstruc�on Plans,Slormwater Plans w/Sflt Fence inskafled, <br /> Sanikary FadiiHas 81 dumpster.Site Wark Permit for all�ew projects.All commercial requlrements.must meet compitance <br /> StGFI PERMIT Attach{2}`sets of Engineered•Plans. <br /> ""'PF20PERlY SUFfVEY requtred for al!NEW cansttuctlon, <br /> Dlrecglon�: � <br /> FIlI aut appllcaBon completely. <br /> Qwmer&Contractor sign back af applicatlon,notarized '� <br /> if aver$2500.a Wo'Etce of Commancement ta required. (d!C upgrades over�P50q) <br /> '* Agent(fior ft�e contractorj or Power of Attomey(for tfie owner}wontd be someone wiih notarized letter irom owner authorizing same <br /> aYER THE COUtdTER PERMFTriNG - (Front of Appification Only} <br /> Reraots IF shingles 3ewers Service llpgrades AfC Fences(PiatfSurveytFootage} <br /> Drlvewaya-Not over Caunter tf an public roadways..needs ROW <br />