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8'13-780-0020 City of Zephyrhilis Permit Application Fax-8�3-780-0021
<br /> Building Department _. _
<br /> Date Recefved ' �''l.7�',�r�l,,;�1�a,Fi'�'�,ca �'�o'-' .�.' �;�°'7'•`��"Js'a�1
<br /> �-�-�_ Phone Contact for Permitting __
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<br /> Owner's Name � � �,;. a � c:. Owner Phone Num6er � _ ,.j�C', ` �j(�, �
<br /> Owner's Address ��������� cr� �n^ ,•� �' '`�'T' `
<br /> � T�'�"'Y°��J� � �Owner Phone Number
<br /> Fee Simple Titleholder Name C �ri. � Owner Phone Number -
<br /> Fee Simple Titleholder Address
<br /> �
<br /> JOB ADDRESS �� ` � • �`!/
<br /> �C i I i C� 1�� �I ' ..LJ Y LOT# ��
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<br /> SUBDIVISION � Si�� lU���'G �� PARCEL ID# . . �''��`�i'�� ^� .. C�� �� ._ . (,C�� ,
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED �NEW CONSTR e ADD/ALT � SIGN � � DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE �� SFR � COMM � OTHER
<br /> TYPE OF CONSTRUCTION ��' BLOCK � FRAME � STEEL � �'— • �
<br /> DESCRIPTION OF WORK In�L'� J��/�C �' �, ��5-r G, � �
<br /> l c• �rv�.� �� .,.�� J`�-` �c�'� �a�::�-�� ,L, .� �,•.
<br /> BUILDING SIZE j SQ FOOTAGE�
<br /> HEIGHT
<br /> �/ �"r'�-r-r�-T-rt-e-r-rr�-�-rm-o-9-�-r-�-rr-e-rrr-r�-e--r-�-e-r-s- �
<br /> �-BUILDING $ ��T°'�`��-�-e�-'
<br /> , r� G1�� VALUATION OF TOTAL CONSTRUCTION
<br /> �'�LECTRICAL $ AMP SERVICE �
<br /> � �� 0 PROGRESS ENERGY � W.R.E.C.
<br /> / �
<br /> OPLUMBING �
<br /> )�J " �/��
<br /> �MECHANICAL $ _ VALUATION OF MECHANICAL INSTALLATION � !/
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<br /> �GAS �/ ROOFING � SPECIALTY � OTHER '
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA
<br /> � f � . 2� / DYES NO
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<br /> BUILDER J� �L � v
<br /> SIGNATURE C✓' �� '� COMPANY �,v,.��'��,--� �'J,.L�
<br /> REGISTERED Y/ N FEE CURRE� �Y/N
<br /> Address ����r� /���-GO.'� ,[� r' IGi�-� �.. ,
<br /> License# ������O !, ;�
<br /> �LECTRICIAN ,�' A
<br /> SIGNi4TURE � /�`�'�''� COMPANY �� G�,n'j?,CJ,�,,,f"',�J',,c� ,�,�{�t�-��"`p �
<br /> REGISI'ERED Y/ N F.EE CURRE� Y/N
<br /> Address 4�d.�y�d-'�,p�/,/'"C� �s �
<br /> � '"` '� ��� License# ( �Q.������,�
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<br /> PLUMBER � `� �� �� � ����� ` �
<br /> SIGNATURE rf��'� — COMPANY ' i 1'"�a,� . .,a,��'�•`��;�;� ,pj�,,�
<br /> REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address f ��f,� 'r��:na���- �1��.�,� � G ��' �
<br /> License# ��"'� [� ,Ir�.
<br /> MECHANICAL Q�� I� ��`
<br /> SIGNA7URE COMPANY '�A`;f � f`�„(,,f�,{f�' �
<br /> � �� ��' REGISTERED � � � � ������
<br /> Y�/ N FEE CURRE� Y/N
<br /> Addr855 _ ���`/� �G1��a�.� �t� /'��a.��'carlf��r:.�'�
<br /> j� License# ����Q,����
<br /> OTHER -,'r�" ,/ ,I � /`��
<br /> SIGNATURE ,� ��'' -... _. - � COMPANY f.1/1�,t"�c`J�f H,/�F)f1,�/r� ,'��,�Ji'f-f,fi�-�
<br /> REGISTERED Y/ N FEE CURRE� Y/N �
<br /> Address , 1�����r �� �� ,
<br /> /��v°�� '�����'� License# `
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<br /> RESIDENTIAL Attach (2) Plot Plans; (2)sets of Building Plans; (1)set of Energy Forms; R-O-W Permit for new construction,
<br /> Minimum ten (10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> 5anitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects
<br /> COMMERCIAL Attach (2)complete sets of Building Plans plus a Life Safety Page; (1)set of Energy Forms. R-O-W Pe�mit for new constructfon.
<br /> Minimum ten (�0)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanftary Facilities&7 dumpster.Site Work Permit for all new projects.All commercial requirements must meet,compliance
<br /> SIGN PERMIT �Attach (2)sets of Engineered.Plans.
<br /> "*"*PROPERTY�SURVEY required for all NEW construction.
<br /> ��i e tions:�-�i_t-t--�--f�-t-�_6-.d..a_I_.y..,0_1_.�..�_I-B--a_k.,d-d_6--E�-•6--6 9_i-�k�G...���,��-�-�-�--G�-9�D�-EL@�9o�3-b_6�p-.
<br /> Fill out application completely.
<br /> Owner�Contractor s(gn back of application,notarized '
<br /> If over$2500,a Notice of Commencement is requtred. (A/C upgrades over$7500)
<br /> *" Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same
<br /> OVER THE COUNTER PERMfTTJNG (copy of contract required) �
<br /> Reroofs if shingles Sewers ;�
<br /> ,ervice Upgrades A/C Fences (Plot/Survey/Footage)
<br /> Driveways-Not over Counter if on;�ublic roadways..needs ROW � � ; , „ � ,
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