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e13-780-0020 City of Zephyrhilis Permit Application FaX a1a-7e°0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting - <br /> r <br /> Ownerr N m�. K 0.c, r� r-� �= Owner Phone Number S Ll 4c 9 6, <br /> Owner's Address �rri�ta ��'j e �" '�' p'r ! Owner Phone Number <br /> Fee Simple Titleholder Name r 1 Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS {{1} _u-Trn 3� LOT# <br /> .SUBDIVISION U c-- �4 PARCEL ID# �•� �r/%` la"�c f 'TU�C� " <br /> (OBTAINED FROM PROPERTY TAX NOTICE) ; <br /> WORK PROPOSED �JNEW CONSTR ADDJALT SIGN DEMOLISH <br /> : 8 "INSTALL 8 REPAIR <br /> PROPOSED USE 0'' SFR C] COMM OTHER' <br /> TYPE OF CONSTRUCTION . i �� BLOCK 0 FRAME STEEL 0 <br /> DESCRIPTION OF WORK ��t•. �� .�' � ,� �l�a'�,^� `� 1`'•-lc c� Z��:'�-�-e 1 --��c�-"�-t. <br /> BUILDING SIZE. SO FOOTAGE HEIGHT* -_� <br /> f-1-1 lei•�tA�>ri<"�"t�1TTlr`T"i—IYT B�Y Y^I�eTt�9—f�P G�" '�r'Y-7^i�rP"P"•����'rY"6'.Ir"[�r'4—G P�4�0"�� 3'��E 9—A�➢� <br /> =BUI'LDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL �6, Q� AMP SERVICE PROGRESS ENERGY C] W.R.E.C. <br /> =PLUMBiNG 7 <br /> 11 <br /> �MECHANiCAL $ VALUATION OF MECHANICAL INSTALLATION t` <br /> =GAS ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS f FLOOD ZONE AREA OYES NO <br /> -1-4-1--1-l-i-l--l-F--!•-8-1-(I-&-Fl--l- UJI-C-•$--1-1-4-1--T-$•-l-Iri�C-zl-3-l-l--H-'�u' <br /> BUILDER COMPANY � � <br /> SIGNATURE t�� REGISTERED Y/ N FEE CURREN Y/N <br /> Address �r 1 l� �>!'<cS.�+r ) i�� - License# '-B <br /> ..F_L.ECTRICIA(V COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address <br /> 0° 57 -'�P 'O�L� r r License# �� �..d z 1� n <br /> PLUMBER COMPANY <br /> .SIGNATURE ' REGISTERED Y/ N FEE CURREN Y/N <br /> Address r�r ?� f fi+ �t� tt r s? License# a FC 0 <br /> MECHANICAL COMPANYA`�i '� �� d " <br /> SIGNATURE f a� '���' ^ _'- REGISTERED Yfi/ N FEE CURREN Y/N <br /> Address � K� f Fr f �a�. f2ac u a "ter. yJ 1 r � License# I C111C C)3�51 4`' 16 <br /> -F.i_ _ -r-_- j7lf f�� ��F,,,e/' <br /> OTHER COMPANY f•'r� _ �-� <br /> SIGNATURE pp REGISTERED Y/ N FEE CURREN Y/N <br /> Address I/ E„cr �J License# <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 /> Sanitary Facilities&1 dumpster;Site Work'Permit for subdivislons/large projects <br /> COMMERCIAL Attach (2)complete sets of Building Plans plus a Life Safety Page; (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 /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.Ail commercial requirements must meet compliance <br /> SIGN PERMIT Attach (2)sets of Engineered Plans. <br /> ""PROPERTY-SURVEY required for ail NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (AIC 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 /> )VER THE COUNTER PERMITTING (copy of contract required) <br /> 1'eroofs if shingles - Sewers C;ervice Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..heeds ROW <br />