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i <br /> aRsasa-oazo '�ity af Zephy�fiills F'ermit Applicafion Fax-813asaoo2� j <br /> � • Building Departmen# I <br /> " I <br /> DaY�Reaelued Phone.Cont�act for P.ermittin - � �� 1 – ���� � <br /> Owaer"s Plame t�t,,,i i � l.S �'C.� Owner Pi�one Number I <br /> � <br /> Owner's Address ww � �" ' � ��� � � Ownor P�one Number C� A � <br /> fee 8impt�7ifl�fiotder Name 1 � Qwner P'hone Pfumber �� � <br /> �e�Simpi�Tittehalder Address <br /> JOB AUDRE�3 � � { 1l, �- Lt1T# �.�,,,� I <br /> �w�V e�ac[c� �1 -a�-�I-ot�� -o��oo-��a ' <br /> s����V����� ������� <br /> (097AfBED FF(OM PROPER'IY 7AX N0710E) ! <br /> Wd�@L PF3CIPOSEp , e iVEW CONSTR 8 ADQ/ALT � SIGid Q � DEMOUSH I <br /> INSTALL REPHIR � <br /> PF�OFOSED:U3E Q SFR [� COMM � OTWER <br /> TYPE tiF G�i�STRUCTtON1 Q BLOCK ' Q FRAME �� BTEEL Q i <br /> `�- - I <br /> DESCR9P�'tOPt OF WQREL �`� �I a-4-i o�. �� -t-�.!! � <br /> �UILDIPIG�12E aQ FOOYAG���� NEIGEIT - � i <br /> � <br /> OBUiLDWG $ ^� �/p�,�AT10iV OF TOTAL CQ1VS"fRfJGT10iV � <br /> QELECTRtCA� �� AMP SERVICE Q PF30GRESS ENERGY Q W.R.E.C. ' <br /> �]PLUMBtNG $ �n�U � � <br /> CC�_� � <br /> QMEGHANICA� $ VALUATiON O�MECHANiCAI.tiV�TAI.LATION l� <br /> � <br /> � <br /> D�s Q ROOFING -[� s��c:a�rr (� or��R <br /> F!NlSHEQ F3.00R ELEVATtONS �_� FLOOD ZOfiiE ARFJ� QYES FIO <br /> �Uii.�Eit COMPANY <br /> �������R� REG3STERED Y J 13 FEE GURRE� Y/N <br /> �ddress Ucense# ( � <br /> �LE'CTRtC1�1 COAAPANY - <br /> SIG�tATURE ' REC,ISTERED Y/ N FEE CURRE� ' Y/W <br /> Ade�r�s� Ucense# �� � � <br /> � <br /> ��,u�B�� can�P�r ���(l�eV�1 �I�ct i Gt�'�(�i� <br /> 3iGNATtlRE REGIS7ERED Y.J-R! FEE CURRER Y/i�) <br /> �adross "'I 1'J��'� 1(l�i'Yl I�'1d. p�CA C '�"� ucense# �-.-�c� `Q� �j GC �� � <br /> — ( <br /> �'tECH�iPtl�AL " COMP1�id1( I <br /> SlGPiAYlJRE t��tsz��� Y! �t �cuR�n Y!N <br /> �ddre�s License# �� i�� <br /> O'PF9�R CORRPI�INY .: <br /> SIGI�I�TU� - REGISTERED Y/ A1 . fEE GURREt� Y/P) <br /> Address - . License#�� �� I <br /> I <br /> R�SlDEPI�'!AL� Attaah{2):Plot.Rlans;..(2)sets of Bvitding�P1ans;(1}sef of Energy Fartns;R�O W Permit for new canstructian, " ! <br /> Mlnimum:ten{90).wrorking:days aftee subiiifita!daie.�.Requfred orsslte,Canstiuc@on'Plans,StormwateFPlans wl Silt Fence insfalted, , <br /> Sanitary Facil[tles&1:;dumpster=SIte�Work_Permit for subdiVisionsAarge projecfs . � <br /> CQ1WtYlERC1RL Attacl�{3)c�omptete sets of Buiiding Rians ptus a Life Safety Page;(1)set af Energy Fortns.R-O-W Permit for new constructlon. - I <br /> Minimum isn(70}warktng days after svbmlttai date. Reqa'sred ons':fe,ConstrucBaa Ptaas,Sfarmwafer Ptans w/8iE#Fenca insfatteci, • � <br /> Sanitary FaciliUes&1 dumpster.Site Work Pettnit for all new proJects.All commercEa!requlrements.must mest compliance - , <br /> S1G�Y PERMiT Attacti(2)sets of Engineered:Pians. . , ' � <br /> ""P120PERTY SURVEY reqaired tor aif,NEW constcuctlan. • <br /> �trections: - <br /> �1!!out agplicalEon completety. <br /> Owner 8 Cantractor slgn bach of appllcatlon,natarized • <br /> If ov�p$2500,�Wokice ag ComQn�nc�anent is r�quired. (dIC upgr�c9es over;�pg00) <br /> " A��at(for tfie contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> ?';�"�a s��GOUt1T�R PERMiTTiNC3 (Front of Application Only) - <br /> � =�;�a�'tc�� �r�rs Service Lipgrades A/C FenCss{PloUSurvey/Footage) ' : <br /> t; <br /> f " . _ _ i <br /> � ., `�s�s-�'������;�!�s.�:ic rcadways..needs ROW . _ <br /> �__.r_�._ __. _ . _ ._. __ _. ._____ i <br /> �_ ' , <br /> , <br /> ` , . � <br />