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81�-��0zp City of Zephyrhiiis Permit Appiication �ax-s��-�so-ooz� <br /> c <br /> ' , � Building Depattment <br /> • Dato RBceived `' i .r � ��� _ �p � <br /> Phone Contact Por Permittin <br /> -3'� . ' `r�Owner Phone... . <br /> _ 3 <br /> Owner's Name I� C_7 j {�,.., Number ' <br /> Qw»er's Address 4 � (f� �7ta 1 Owi�er Phonc Number �� <br /> Fee Slmple Tkleholder Neme �� � Owcrer Phone Numher � �� <br /> Fea Simplo 7tUeholder Addreas <br /> d08ADIIRESS �� t 18T� �� <br /> SUBDMSION /"02 i'�1 � bl�'ti 1�..d1� �PARCEL ID� � ��a'J' - �)�-�,?-.�� � <br /> (Q87liSf?EDFR6t5 TAXNOTICE) <br /> I WORK PROpQSED e NEw CONS7R 8 ADD/AI.T �� SIGN Q DEMOLISH <br /> iN5TAL1. R[PAIR <br />, PttqPOSED t{SE � SFR Q COMM � QTHEf2 <br /> TYPE OF CONSTRUCTIQN Q BLQCK Q FRA(NE � STEEL Q <br /> ' h S!-4.!t a ('1'tw R� <br /> DESCRtPT[ON OF WORK .�+4 ,y-1�^+oo I�.���,c�y/ +{-� �,Z,�v,�,{-.�-,�C�-^�� ' �n v � �I/�a-rvi�•R�'�'� <br /> 1��YzG�-ry.�a.0 S�� <br /> Utl.DiNG S12E ��� 5Q P047AGE�� HEIGHT ��� <br /> � '"Y`-' Uf�f�2 Cr�7(�����' , 1 VALUATION OF TOTAL CONSTRUCTIQN <br /> �� J <br /> /r� '_' LECTRICAL' $ ✓�_� AMP SERVIGE Q PROGRE35 FNEFtGY Q W.F2.�.C. � <br /> r � � � <br /> Q��.unaa;r�� � c�G <br /> QMEGHANICA� $ VALUA710t3 OF MEC:MAN3CAL 1PtSTA1l.ATION �/4��4��r�f�� <br /> QGAS � ROOFING Q SPECIALTY � OTHER �� <br /> f1NISFiED FtOQf2 EIEVATiONS ��� FL001}ZONE AftfA QYE3 t�i0 <br /> BU1t.0ER � � COMPAi�SY � <br /> SIGNATURE � r��Is�o Y/N �e Gurtraen Y/N � <br /> Address t,tcense#�� � <br /> ELEC77aC1lW �,Q, �y� con��awr � (l� �1Ch �'!'�'il'P � <br /> SIGt+QfiTi3RE REG�STEszEQ �Y't�„j �Cuettz�n Y 1 CF <br /> Atldress "1�"i� � �( � JJ-��3 Ltcense� 6��•.(X��c�__t�� <br /> PLUM6ER � � COMPANY � <br /> SIGNATURE � REGI5TERED Y/ N FEF CIIRRE� Y/N <br /> Addrass ticense#� � <br /> MECHANICAL � � COMPANY � <br /> SlGNATURE � REG3S'tErz�o .Y,J N FE�p1RREn Y t iV <br /> Acldross license# ( �� <br /> OTHER � � COhqPANY � <br /> SIGNATURE � � REGISTEREO 'Y 1 N FEE CURREA Y/N <br /> Address License#�- � <br /> IIAIIllillllll1111lIIIIIABIIAtIl11111111Y111111111111181l1111111lAI <br /> '�, RESIDENT}A!. Attsch{2}Plot Plans;{2)sets of Suiiding Ptans;(t j sef of Ertergy Pocros;R-0-W Permii tor aew construCtion, <br /> F�finimum fen{�t0}xmrtsirsg days gfter suhm's[tak date. t2equired ansite,C4n:trtscfian Plans,Storrzn:ater Ptan�rut SiEf Fence insfalted, <br /> Sanitary Facilities&1 dumpster,Site Work Pettnit tor su6divisionsAarge projecfs <br /> COMMERCIAL Attach(3)compfete sets of BuHding Plans plus a L'rfe Safefy Page;(1)set of Energy Forms.R-O-W Permit fw new construdion. <br /> Ntinimum ten{14)woctcing days aRer sutsmiiL�zi date. Required onsite,Construcfian Flans,Stotmwater Plans wl Si1t Fet3ce instatted, <br /> Sanitary Faci{ities&1 dumpster.Site Watit Petmit f�ail new projeGs.Att cnmmerciat requirements must meet compliance <br /> , SIGN pERMIT Attach(2)sets af Engineered Plans. <br /> i <br /> ""PROPERN SURVEV required for all NEVJ construction. <br /> � as►ecttons: ' <br /> � Fill out application completely. <br /> � Ovmer&CotiVactor&ign back oE application,nota�zed <br /> � if over 52500,a Notice af Commencemeat is requtred. {AdC apgtsdes over STSk3D} <br /> " Agent(fa the contracCor)or Power of Attemey(for ihe avmer)would be someone with notarized letter from owner authwtzing same <br /> OVER THE C4tJNTER PERMRTING (Front of Applicatian Onty) <br /> � FZcraois if shingtes Sewe3ts Service ilp�ados NG Fences{PloVSurvoylFoat�go} /�,p�q�p,�y(� <br /> �I 'q'`�Y`PUBCi�'� S�����YSI'Y�E H[10r� <br /> DHve4vays-Not atier Counter(f an pu4lic road�+ays.,needs ROW _ �1` "�� <br /> -• '€ MY Gt?MM155lON�rFF170898 <br /> ``�.F�04:� EXpiF��S Clctol��r 22,2018 <br /> � ��07��;�8.a�5;� �IoridaNataiy5ertice.com <br />