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<br /> , 813,780-0020 City of Zephyrh(Ils Permit Applicaiion Fax-8�3-780-0021
<br /> Bullding Departmonl
<br /> � p�to Receivod r 2�/ }�,� �8� •
<br /> y-r-i-�-Y-i PhonoContaetlorPormftttnq �J U VQf Z!S
<br /> J�,�pr i6e � c �
<br /> Owncr's Namc ���lcs oC?�(�*�rfl��ll'a��y��,
<br /> ._,__�; OwnorPhonoNumbor
<br /> � Ownor'eAddross �20 �r+�{.�/tr. �.c{.��1tiJfi(ls�F(, 3�yZ �'�"'� I
<br /> Owncr Phone Numbcr �
<br /> , Fon&Implu Titteholdar Nama �`�'"�'"�
<br /> OwnarphoneNumbor � I
<br /> , Fea Slmple Tllloholdap Address "'�'�
<br /> �
<br /> �oenportEss �4U35 Correiri.Dr. � � •
<br /> � � LOT p S
<br /> SUBDIVlSIDN �7f4`OG C�'kr I�1-2-(c -Z2-pOlO�
<br /> PARCE1.IDk _ �cX�0.��005U �
<br /> WORK PROPOSED � tO�iAiNED F7i0M PROpER7Y 7qX NOTIC[)
<br /> NEWCON57R ADO'/A�T L] SIGN Q � DEMOLISFI
<br /> INSTALL � �Ep��R
<br /> PROPOSFO USE Q SFft Q COMM Q OTHEI2
<br /> TYPE OF COWS7RUCTION �] BLOCK [� FRAME �� STEEL � r'----------+ �
<br /> DESCRIpT10N OF WORK N�w nM.+ai f3wid�ncJ v�1•�(� O�'��� j�����. i
<br /> ---------
<br /> 6UILDING 3t2E SQ Fo07AGE I�i�00 HEIaNT v0�Or�e5S +
<br /> BUIIDWG I
<br /> ��3 D,CS� " VALUATiON OF TOTAL CONSTRUC710N �
<br /> �FLECTRIC�L • 5`I�'S�,� AMP SERVICE n PROGRESS ENERGY
<br /> , O w.R.�.c.
<br /> QPLUM0ING 3 ,
<br /> _ Zb��6 �
<br /> [�M6CHANICI�L S VALUATION OF MECNANICAI.INSTALLATION,
<br /> Jr��Gr.�O �
<br /> ' OGA9 Q 'ROOFING Q SpECIAL7y � OTHER
<br /> FINISHED FLOOR El,[VATIONS � FLDOD 20NE AREq ,
<br /> QYES Np
<br /> BUILDER � � I
<br /> SIGNATU�tE � COMPANY ��'(��� �n5;'f�{167�p�'�p��� ���
<br /> RccisT[inen Y N FGE CU}iHE� Y N
<br /> �ad�o88 �1i a�R �t, � ra��us,F 33541 ---� ,
<br /> licensa!1 �G G 1 S(�"l'1'i 2
<br /> ELECTRICIAN CQMPANY ��4i'� �-fCc�/iG
<br /> S�GNATURE
<br /> RL'W9TCREp N FEGCURR£� ry
<br /> , Address p� �K�{3'1, Q�(e C�4 �, 3�j2(�• ,
<br /> � licenso M�
<br /> PLUMBER COMPANY ��Ph'n p'���
<br /> � SIGNl�TURE
<br /> ' REOISiERED /N FEF CURRf:A ry
<br /> = adaress R)f3ox 3'Z3S,�{x^'�nrj F4ill �, 3�(bll
<br /> � ucon�olt GfL I�SZt3zo�
<br /> MECHANICAL �y""��p � � I
<br /> • SIGNATURE (/���►�+�. COMPAfVY C�S ��G'
<br /> REGISTEitED N FEE C4IRREM1 �/pJ ' �
<br /> � Address `�Y�lf f�l(�n Rd.��c rh'd�5� Fc.. 336�!( �
<br /> Llconsc# �[S �{-� ,�f:.�
<br /> O?NER '
<br /> 81GNA7UR6 COMpANY �
<br /> _ aealsreRr_n Y/N r ec cur+rt�r, Y J N �
<br /> • . Addross
<br /> � t11111111 � 11111111111111111t0111 / 111l0111111t1tic11111l1lIIIft1111111 �
<br /> RESIDENTIAI �ttach(Z)Plot Plans;(2)sots of Bullding plana;(1)aot of Enorpy Form�;R-0-W pprm4 for now construction, f
<br /> Mlnimum fon(10)Krorkin�days oflor eubmittnl dMo. Requirod vnsito,Construqfon Plans,Slormwa(er Plana w/SUt Fence InalnUed, �
<br /> CDMMFRCULL Atlneh{2)complele sel�ofpBu Iding Plans p us o Llfor5 fety Pnpo3(�)srtl f Enorgy Formo.R-O-W pU��t�or now consvucffon.
<br /> i
<br /> Minlmum fon(10)�+rorkiny days aRcr submittal dato.Rnqufred onafte,ConsMuctlon Plana,9lormwatcr Plans v�/5flt Fe�a Installod, �
<br /> Satrilury Fadiitleu 6 1 dumpst�r.5ite Wark permit for fill new proJects.All commnrciat requlrematta must meet cnmp+fenco I
<br /> StGN PERMIT Adacli(2)sets of Enginecred plens,
<br /> ""PROPERTY SURVEY requirod tor all NEW consVUCtlan.
<br /> Dlrccdons:
<br /> i
<br /> Fill out np�liwibn complotely, �
<br /> Ownor 8 Contractnr sign back of appncatton.hotnrized j
<br /> li over 52500,a Noticp o/Commencemoht is�aqulred. (q!C upgrades ovor 57500) �
<br /> " Apont(/o�tho canlractor)or Power of,�AUornpy,(foa,the,awn�r)woWd.bo 5omeono wilh notnrized lotter trom ciyncr outlto�ri�Jnp ssmo �
<br /> OV[R THE COUNT[R PERMITTiNG ° (<opy of conV'nct roqutrod) :-' r
<br /> Rr.roofu If sliingies 5ewers Senrico Upphdes NC Fencas(PI�tlSurvoy/Footnpe)
<br /> Drivowoys•Not ovor Counter H on public roadways,.nnr_da ROW '
<br /> 1 , .., w. , ..� ..� , �.. , ,
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