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$��-7$o-aa2a City of ZephyrhiHs Permit Appiication Fax$13-780-0029
<br /> , ^ • � Building Department
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<br /> Date Recelved .. •phone Contact�for Permittin �
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<br /> Owrner's Name ( � �� Qwner Phane Number G`J �J �� ,�
<br />' „ , ��, Owner's Address 4� / W� Owner phone Number
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<br />� Fee Simpte Titlehotder Name ��� �- Owner Phone Number � �
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<br />'�, Fee Simple Tittehotder Addr.ess
<br />' JOB ADDRESS � t/ � // � �/ `��7 2 �or# ��
<br /> sus��v�s�o�t -�t�,���t�":L.. I �aRc��.�� `�- ^ �G� � 'C,3
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<br /> (OBTWNED FRdM PROPERTY TAX NOTIG6).
<br /> WORK�ROPQSED e ,- IVEW CONSTR 8 ADDTAL.T � SIGN Q � Q DEMOi�iSH
<br /> INSTALt; °FtEPAIFi
<br /> PRpP.,OSED.USE Q SFR Q GONlM 0 OTHER
<br /> 'iYPE`:OF CQNSTftUCT(ON Q" BLOCK - Q. �FRAME � ' STEEL Q
<br /> tip /� /� "�
<br /> OESCRIPTICIN OF WORK �C. ' i�' t' �"C> ' G--
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<br /> BUIGp11VG`SIZE SQ FOO`TAGE NEIGMT ����
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<br /> OBUILDING � � yA�tJATIOt+!'OF TOTA�CONSTF2l1CT101U
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<br /> �_El.ECTf�iCAL � � AiVlP SE12YlCE Q PRQGRESS Et1ERGY Q W.R.E.C.
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<br /> OPLUMBING � � � ���
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<br /> MEGHANICAL $ x° 4� VALUATION OF MECHANICAL INSTALLATION �
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<br /> Q;GA& Q ROQFWG �], SPEClALTY Q OTHER �
<br /> FINISMED FLQOR ELEVATIONS �� FLOOd ZONE AREA QYES NO
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<br /> = :BUl�DER 1 COt�RPAAl1Y
<br /> SIGNATURE REGISTEREp Y/ N FEE CURRE� Y/N
<br /> , 1�C1dr8SS _ LiC@ttSe# �� ��
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<br /> ,'.=ELECTftIGfAN . CONIRAisY
<br /> ,_�;.SIGNATURE REGIS7EREp Y/ N �FEE%CURRE� ' Y/N.
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<br /> J Addrass ` � - Zlcense# �� '� �
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<br /> ,=. P.LUMBER;;. . 'CONIPANY�• ,
<br /> � .SIGNi4TURE 4 �� � �REGISTERED Y/ N • FEE CURRE� Y/N
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<br /> � . Address - � -Licertse#`�� �
<br /> , =�MECHi4NlCAG._' ,�r�' „b�,,.,� COMFANY Gtc�Z ` �
<br /> v'`�SIGNATURE'"�' �' �` �: '+ G.�� � REGISTERED , Y N , FEE.CURRE� . . Y/N .
<br /> , aaa�8$sw7� 1�'4 � d'l i�cense.# !��/��.s ,��� i
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<br /> '';�OTFiER�� �'x:`:: , - . ' ` 'COMi?ANY - .
<br /> ,`�SIGNQ►TURE:r{•t'ra ' - • ' ' REGIS7ERED Y/.N FEE CURREK Y/N
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<br /> . Rddress�:r ��_� ;A�>,-:_ � _ - - `Li'fense#
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<br /> i::;RESiDEN71AL:���. �:Attacfi;,{2};Ftot�Plansr:(2)�efs`of<Bulidiiig�l?lans;(1�}`set of�Enetgy`�Forins;R=O=IjY Periiilt foc-new.constivction,
<br /> ,...+3�t^: " ' . - . . � . � - .. .S. . , + �
<br /> =::�ir�4:.-�.��y Minimum ten°(1O,�wo�king='days:after"s,y6rriittal:�late.'�Reqnired�'onsfte;Constr'uction Plans;Stomnwater�Pla�s w/Silt Fence installed;
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<br /> E���;�;<. . Sanitary,FacillGes�#&�1�.dumpster;nSlfe�Work:Permit.foYrrsybdivisions(�arge";pro]eets".'. ^ '��,'• - .- ..:-- - - — -
<br /> �-`GOMMERGIAI. Attacli>{2)�corriptete`sefs`af`Bulliiiiig Pfans ptus a�Ife Safety Page;{i}set af Energy Farms.R-CJ-W Permlt for new canstruction.
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<br /> ;�?��� - Minlmum ten(10)working days after submittal date. Required ons(te,Construction Plans,Stormwater Plans w/Silt Fence.installed,
<br /> �:''s�: Sanitary Facili@es&1 dumpster.Slte Wotk Permit foF�allwnew.proJects.All co[r�mercial requlrements must meet compliance
<br /> s�.;_8iGN:PERMIT "Attach{�}se�:o.f;Eagineecerl,f?ians:=��:-,,.. . �" .: }.
<br /> fi(��'�;�~=` "'"*PROR.ERTY SURVEY reguired for.all,NEW canstructian:.
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<br /> :���(BCt�Or1$: ,. .,;-c5ta'^ ,tis`_ii s . '
<br /> ;��"' ����Fill�:out application completely.
<br /> i;`,, t?uuner&-Eantractor,sign.back of appltcatton,notarized
<br /> ;t`� if pver.;$2640;_a Notice.of:Commencement is required. (A!C upgrades over$750Q)
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<br /> ��."`` A anY for�tfi'e�contracto�=or-Power'ofAtiome'`for the owner would tie someone wlth notarized letter from owner autha�izin same "
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<br /> 1»ONER:TNE.COE7NTER�PERMI.;TT:iNG:.v.,, ;_(copy..af»contract�reguired) � '''`""
<br /> :�'Reroofs,if:sliirigles � Sewers Service Upgrades,NC Fences(Plot/Survey/Footage) ,
<br /> - ...-y.. ..=r.,:..;..�}a:d;i,'•:.i� '-.
<br /> " :D'rlveways-Not over Coun#er if on pubtic roadways..need`s ROW
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