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,, a�s-Taauo2o City of Zephyrhii{s Perrriit Appiication F�:-s��-�ao-eo�� <br /> �. Buifdir,q Dep�stmc�nt ` <br /> . DatQ ittieelvod phone Contact for Permittinq �3 . �O��o- 3�� <br /> _7.��_�.i l._�.�..i. �-L'C' >..L_.S7"a'Ll..:i. I i�Ci'1 C'71..�...�f'*�..r .... <br /> Ow�or's Name . P� Owner Phons Plumber� " l��0<1 � <br /> Owner's Address "lVl` W'S�ld �( Owne�Phona Number .��� <br /> Feo Simple 7ltleholder Name �'J -- `� CSw�ier Phona'Numbsr ( � <br /> Pce Simple Titiehoider Address � � <br /> JOB ADDRES8 y(9��1 W�c��(iu�t,7�� �11��.���L1� �or# �._3 � <br /> � s�ga�v���a� . UJn� � s �A����.�n� �5 a6 ai-d�o-o0000.po��� <br /> � � (OE4TNl3ED FROM pROPERTY TA%NOTIC6) � <br /> WdRKPROPOSED NE�NCONSTR ApqfAlT � SIf3N � Q DEAi�LISN <br /> e INS'fAl.4 8 Fi�PAlft <br /> PROPQSED U5E �� SFR Q COPdM � 0711ER ���-�-�� <br /> , rir��t��coNsrRucnora [� , s���c:kc (� ��arn�. � s°r��G [� - - <br /> bEBCRIPT101V OF WOt2K �Sh e) �F'UO�aW-C���t �'�rr'c5a2�}t- lk1l�' <br /> , BUILd1NCz S128 �_ � Sq FOOTAGE _1�•� NEIC,iHT �� <br /> . � <br /> �BUILOING ' � ��I VAIUATIqN OF TOTAL CONSTRUCTiOtd \ <br /> Q[LECTRICAL ($ —� AMP SERVICE Q Pi20GftESS ENERGY Q W.R.E.C. <br /> �PLllR'181NG l� , r��/ 1 <br /> �li l�CJ <br /> . L�MECHANIGAL $ VALUATIUN UF MECHANICJiL INSTALLATiOt�t •'��� <br /> QGAS R04FING � SPECiAL"fY 0 OTNER <br /> FlNISHED FLOOR El.EVATIONS FLOODZONE AREA �YES NO <br /> BUI4,O8R .C6MPANY ��O�D�11 P� �'K�`�"� <br /> SIGNA7URE ta�cis7�Fa Y i�4 r�x cuatc�q .Y/N <br /> A�dress �`� License q ( �—t <br /> ELEC7RICIAN COMPANY ������ <br /> ' SICit�tAA7�RE ru:r,is'r�eo Y i N FEe curtst�n Y 1 N <br /> kddreas __� Licensfli; �_ <br /> PlUfABER � � COMPANY �__+^ <br /> 3lt3tdATllRE aEcrsrcaco Y i N Fs�cu��n Y!N <br /> Address V`M.-� licQii,e# � � <br /> M�CHANICAt. GbMPANY I <br /> ` - SIGNATURE �� rz�cisTEr�o` Y!N rceCurzReh Y!N <br /> Addrosa �License 91��`� <br /> OTHER � � GflAAPAtdY � <br /> SI(3NATURE � � r�ais'rEN� Y�N F�s cuaaK� Y I N <br /> . Address t.iconso��__� 1� , <br /> ' � � � � � i:� � � i � � ii� � i � � t � a � � � � � �.�.� e � � � � e � � � � i � e � i � � � � i � � ae � � � i � � e � � �.� � � <br /> RE510ENTIAt At[ach(2)Wot Pians;(2)sets of Buildi�g Plans;(1)set o1 Gnergy Forn�s;i't•C7-L"J Pemiit ior�ew sonsiruction, � <br /> Minimurr�ten(10)workinc�day5 atiers4ibmiU71 data. Requfred ansite,Construci�on Plnns,Stormwat¢r Pians wJ Silt�onCt�insialiar.l, <br /> Snnitary FOailiti�ss:&1 dump5ter;Site Werk Permit for siibdivisions�7nryfi projor.ts <br /> COMMERGlAt .Aitnch(2}rnmplete sets of Buiiding Plar.s plus a Lifu Safely Pac,7s;(1)s4t nf Enargy.Forms.ft=0-LV Permit far new car�slruclian. <br /> Miri,mum t�rn(10)'tivcrrkiny�ieys,aftor subniltlat dnte. R�quirc+ai ansile.Constriict�an Piens,Siormwater P�ans w/51t funce instal{ed, <br /> Sanitary'Fac�ilios&1 dumpstea Site Wcrk Permit for a1!now pmjocis:Al3'cammrsrcial ntqukemenls must meot compti3nCe . <br /> 31(3N PERMtT Ailach(2)sets of Ertglnsered Piz�n.s. ` <br /> ••'°PFtOpERTY S1�RVGY requir�2tl tor ai11 NE�1 cnnstruction. <br /> Diroctions: " <br /> , Fdl out ap�ilc.�ticn cz�mpletaly. , , , <br /> t)wner:8 Confracinr sign back oPappNcatton;notarized � <br /> !(avor 52500,a Notica oi Commencem�nt is requ(rad. jAtG upgrados o"ver$75fl4) <br /> •• A�crnt(for ihcr canttactor)nr Pms�er ai Attontc�y(tor the owmGr),xoulri be s4mFann w±ih nntmrized letter fm�n owner aulhoriz;ng seme <br /> - OVER TWE COUNTER PERM!ITING {wpy af cont�ct rcquirod� <br /> Raroafs If shingies 5ewers Servir.a Upgtades Ni, Fences(f'IoVSun+oyi�r,rotagi�) <br /> Ortvowayn•Nrt ovar Cnunter if on publio ruadw�ys..needs RO�h� <br />