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' � <br /> . <br /> e��-�� City af Zephyfiills Permit Application �a�c�t�-7saoa2s <br /> ti B�ng D�artrnent <br /> DabeReoeived PhonaCadadtor Ol – �L�r <br /> OMrt�'s Flarne ��_� �� Owtn�'Ptlotfe[+hanbat o� �,,,,�,�,,,rr"/� , <br /> � <br /> Owe�er�s fiddres� L��Glc Oyrnes Plrone Ddmtbe�' � <br /> Fee Simpte TRSe1�Nalr�e ( —l---� Owner Phone N�tbe[ �' � � <br /> Fee Sirnpk litletroldei'Ad�s <br /> J08 ADDRFSS � /c! ��. G'��J.S LOT# �� <br /> suBonnstcr� ��C��� ori�o� Pa�.u* 3 �S--a�1��1�1�� D1.�40D D��D <br /> �,/' �����r�,�, � <br /> WORK PRCPOSED CI NEW CONSrR� ADD/AI.T [� SIGN [� [� DEMDt.tSH <br /> (� iNSTALL REF?AIR <br /> pROPpSED USE Q SFR Q COMON � OTHER <br /> TYPE QF COM&TRUCTlON Q BLOCIC � FRAME � S?EEL � <br /> DESCFUFf1QNOFWORK C: (i G�''l�fl-� "7 �D Gi1J��77 �.,'NT �e ZY� <br /> BUILQING S�E SR FOOTAGE HE13HT �� <br /> QBUlLD1NG � ��I VALUA710t�t QF TOTAL CQNSTRUCTlON <br /> J <br /> Q ELECTRlGii. �� AN�SFRYICE - Q PROGRESS EN�RGY p w.�.e.c. <br /> QPLUMBiNG r--� <br /> � <br /> pn�c,Nawcru. s �'�`��i� vn�.ux-noN o�n,�ct�u►r�ic�u.�r�s,s�ut�oH <br /> QGAS Q ROOFlNG Q SPECIAL7Y� OTNER <br /> , FINISHED PL.00R ElEVATlONS �"'� FCOOD ZQNE ARE/1 QYES NO <br /> �_« <br /> BUILDER �—! � �p/�,y � <br /> SIGNA'T�712E 1�3tb1'� Y t PI- PEE cuRREA Y t!V <br /> aaa� u���i 1 <br /> ElECTRtCUW � � C014PAMr � <br /> 3IGkA'RJR6 rsEGwT�Ea Y J N �W tu� Y 1 N <br /> Addrcss �#�� <br /> ' SIt�HATURE � � REti�it� Y 1 N FEE cU3iREA Y!ft � <br /> � � �.� �����. �.� <br /> I r�ecr�,uca. ` ��Yj�,2y.�,,f,,,, co�awr �'1-�R 55�r�Pi4i�lt� 1�-�� <br /> SIGNATURP ttr�� Y/�N �cula� Y/�N _ <br /> Addn:ss ! 7"� f/�.'l�,j - Lit�tfse# G.rT � <br /> � �'rMER � � CW�tPANY i � � <br /> � StGNA'TURE REotsT�D Y t.N F�e cU�B. Y f N <br /> ,� �#r � <br /> � � � � � � ice � i�� � � ir � ��t�� t �-r� t � � ��r �-Ye � r�i � � i � �i.�ti � � � � � ��_� i � � it � � i � � � � � � <br /> RESIDH�ffU1l. Attach(2j Ptah Plar�s:.(2)sels of Bwldfng Placs;(1)set o}Ertergy Fatns;RA�W Fermit for new�ion, <br /> MGnimurn ten(10)rwddn9 days a�r subnuttal deEe. Requrted oraiOe,C�ori Pians,Stormx+ater Ptazs w/Silt Fer�e insmued, <br /> SanitarY Fata5tles 81 dumPst�;Sita VYaic Pertnft fw sua�o�atga�eds <br /> C�A[RCtAL Aifach(2)campdete se�ef 8catd'osg Pkvs P�a E3fe SafetS+Pa9e;(1)set of Ettergy Fomts.R-O-W Permit for ieaw�_ <br /> NSn�rm ten tt0?u�arl�ss9 days�ter subsnit�t daie.�Reqt�sed a�ite.C�P1ans.Si�nm+ater Pler�s w/Sitt Ferke h�talled. <br /> i Sanitary Fap!'Nes&!durttPster 8ite Wotk Petmii for eU new projects.All awnmerp2l repuiremeMs must rtteef canpliat�e <br />� StGN PEl�AII' Attach(2)ssts of Eng6�aereii Pfet�. . <br /> '""PROPERTY SURVEY raquued for ap NEW ppnshyc�ian. <br /> :_... . . . . .. . . ... . . . . . ... . . . . . . . . . . .. . . . . . . <br /> DEre�ehor�s: <br /> Fill out applit�tlan canpletely. <br /> Owner&Contradcr sign back of appficaHon,rtotat¢ed <br /> :•-tt over 32500�a NaSce oi.Conae�enceenenE bs�u�ad. i���.aver ST5ony ' <br /> "',� Agent(for tli9 cartradorj w PowBr of At�orney(fPfUlo oVmer)wouid De sartu:orle wifh nOt�t¢8d tetter frDm oNmet auCtoli�tg seme <br /> OVER 7FIE COUMER PERMITnNG (copy.af aorrtract reQulred)' <br /> Renoofs if shin9� Sewers Sarvit:e tlp�rades A!C Fe�es i��rtl3urveYJFoo�ge) <br /> : cr�ve�ys-r,�or over cwn�cer K on Rut�C roaaways..r�e�Row ' <br />