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813-7UU-0020 City of ZephyrhillS Permit Application / -"�"
<br /> Building Department �,�Lr.� f.-(,(J/1\/
<br /> r
<br /> Date Receivedphone Contact-,for•Permitting ..:• r
<br /> Owner's Name L LA �4 ,f Owner Phone Number
<br /> (1 0 �3
<br /> Owner's Address: 5 b �� + L /�Xl C Owiner'Phone Number
<br /> Fee Simple-Titleholder Name' Owner-'Phone Number,
<br /> Fee Simple Titleholder Address AS
<br /> JOB ADDRESS S� �c� -I �)L Lf LOT# I
<br /> is
<br /> SUBDIVISION• PARCEL.ID# 6i;J*00)O,() O.t7 q4)
<br /> (OBTAINEO:FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED NEW:CONSTR' ADD/ALT 0 SIGN Q J. DEMOLISH
<br /> INSTALL 8•. REPAIR
<br /> E] .PROPOSED;USE- SFR 0. ' :..Cow 0 OTHER '' <'
<br /> TYPE'-OF 6-ONSTff6CTI6N BLOCK 0 •'FRAME Q, " STEEL 0.
<br /> DESCRIPTION OF WORK
<br /> =r��Atvi�/ d'8. 1
<br /> BUILDING,-SIZE SQ FOOTAGE LL
<br /> �.
<br /> --------------
<br /> QBUILDING $ VALUAT:ION'OF TOTAL CONSTRUCTION
<br /> =.ELECTRICAL $ V . AMP SERVICE -PROGRESS ENERGY Q W.R.E.C.
<br /> QFLUMBING. $ CIJ.l otL 1vx/)(7s
<br /> ' I��
<br /> MECHANICAL $ VALUATION OF MECHANICAL NGSTALLAMON l /►�J j�� j�G L`O1�
<br /> QGAS Ef ROOFING Q, SPECIALTY. Q OTHER.
<br /> FINISHED{FLOOR ELEVATIONS 3d v FLOOD ZONE AREA 0 YES. NO
<br /> < .
<br /> :BUILDER: 26 ( COMPANY 1 � � �`�0�- tul
<br /> SIGNATURE UU t l�V v I J REGISTERED Y/ N.;.' :FEE,,CURREI f Y/
<br /> Address 2 S G 'A WV .. :License; . .
<br /> #' �ri (?Q, G 1?IV
<br /> f -ELECT RICUIN COMPANY
<br /> "SIGNATURE REGISTERED Y/ N • FEE cl1RRER,.`• Y/N.
<br /> Address` License#
<br /> PLUMBER:., COINPANY::;_
<br /> SIGNATURE_` REGISTERED Y/ N:
<br /> Address. License-4
<br /> -.MECHANICAL`'' :.COMPANY:.'.
<br /> SIGNATURE.` . "REGISTERED Y/.'�N FEE CURREK: . Y//N.
<br /> License.#
<br /> .�:.:OTHEFt=::�..,;_.,;;,::- .. r:•.: _ .>. - - . ,:.-.;•COiNPAP1Y...
<br /> IGNATURE;;t;'„ > _ REGISTERED Y/..N FMCURREK Y/N
<br /> :. 77
<br /> .
<br /> `_79"-^i„S'.'. - -- - - �t:r �,',�^46 a�C-x:. -.:.ri,..ax`Fg�i�:•:"'+, ,, .�. .. _.
<br /> E 'ID NTI 2 5PI't'PI"ns `2 s ts:of>Buik Ifs-,``splans` 1 set of Ene Forms R-0�V11 Paemili r.riew construction;,
<br /> w.:-:; .>_.. .1Wnimurrttenpp(�1Q„,,"CLorkin :ta's afters�bmittai:date'c Re wired'<oiisite`Gonstru'ctlon Plans;Stonnwater'Plri§w/SiltFence installed;
<br /> ,:�.,:. .-':'•'..a:,y.t:!n,;v:?,:-ag-;�.%Y_w.:%:e.+.�"•`.•. 1•a-•..,c.g. .Y.s�. - q - - -
<br /> :; Sanita t xrmcilitiesa&r.�lydum ste.+CSIts,,.W.orfc[?ermlt:forsutidiv]siops/a. e`'ro acts'. '"'
<br /> ,. ;:IOfNMERCIAL Attaich'•2•=edm lete'sets of`Buildlir 'Paris�lus a'life�Safe "Ps e; 1 set of Ene Forms.R-O-W Permitfor=new construction:
<br /> Minimum ter,(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence.installed,
<br /> Sanitary Fatuities&•1 dumpster.Site Work Permit fdt4ll=new-projects.All commercial requirements•must meet compliance
<br /> T=SIGN:PERMIT Attaoli•(27 setsgfEegineeted)Plaptss
<br /> "•••PROPERTY SURVEY required;gr..aII,NEW,construction.w.
<br /> �ire6t101187
<br /> �'�'"�:``'�F(Ilioutapplication.completely. i4 ,
<br /> Owner.:&"Contractor sigIrtback of application,notarised
<br /> I1:over:'$2500;.a,Notice;of:Commencement Is required. (AIC upgrades over$7500)
<br /> gent(for th'ercontractor)tor Povyer-of Attorhey'(for'the owner),would'tie someone with notarized letter from owner authorizing same
<br /> '01lER TFtE COUN!TAAjP iN TTING:..,..,::..(.copy of:contract�required);.--
<br /> Reroofs.ffsfiingles Sewers Service Upgrades.A/C Fences(Plot(Survey/Footage)
<br /> 'Driveways-Not over Counter iron pUblieroadi ays needs'ROW
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