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813-78D-OM City of Zophyrhilis Permit Application Fax413-7110=1 <br /> Building Department <br /> Dato RmInd cap- zo I Phone Contact Iforipormituns <br /> - - .. .. .. .. -a - <br /> 19 :0 D v a 9 U U 0 U ' ' - - ----7 111�-I ! <br /> Ommmef%Nam Ow.,Ph..Number 7 <br /> Owners Ad: <br /> C ,LA 0 <br /> 0 vv 1W IOwner Phow Number <br /> Fee Simple :aIda Name own sr PhoneNumber <br /> Fee Slrh*Tifsholde Address <br /> .toe ADDRESS 9 oL MeA v c W <br /> LOT# <br /> SUBOMION Mekv%zoo d 4$ PARCEL IDII 73-4- - / M W -0 <br /> (01TANEDM01FRWERrYTAX10121) <br /> WORKPAOMED R NEWCONSTRL ADDIALT SIGN DEMOLISH <br /> INSTALL <br /> REPAIR <br /> PROPOSED USE = SFR = COMM OTHER <br /> TYPE OF OON87MRU M BL3PK FRAME = MEL <br /> 51thn <br /> uEscRw".nomOF RK <br /> BUILMNO 52E 80 FOOTAGE= HEIGHT <br /> .. . ... .. .. . <br /> r-7BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRIC IS AMP SERVICE r'-J PROGRESS ENERGY Q W FLE-C. <br /> F-1PLUMBING 1$ <br /> k3MECHANIC'kL 1, 10,71-7 -1 VALUATION OF MECHANICAL.INSTALLATION <br /> MGM r7 ROOFING [:3 SPECIALTY = OTHER <br /> FINISHED DNS FLOOD ZONE AREA AYES NO <br /> —FLOOR <br /> — . . . . . . . . . . . . . . . . . . . <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED [-YIN FEE CURREN LXLN_j <br /> Address Uowm#F— <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I YIN FEE CURRM LyjN J <br /> Address D J U.-# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I YIN FEE CURREIN <br /> Address n LICWM# <br /> MECHANICAL COMPANY ;MD—S <br /> SIGNATURE tit REGISTERED .1 YIN FEE cuRm I YIN <br /> Address to C-t)"e AV e-- U.# <br /> OTHER. COMPANY <br /> SIGNATURE REGISTERED I YIN FEE CVRREK L.L/_N <br /> Address U.# <br /> 1 <br /> -e-F-1 I 11-f1 <br /> 11 '*RESIDENTIAL (2)Plot Pierce;(2)oats of BuUdIng Plaw, set of EneW Forms,R-O-W Penn for now construdon, <br /> puft-wt Ut <br /> CWdfucft'P J8KSftnw8F*F S Fantainstatted; <br /> FsWrds&&1 dumpster;Sits Work Pernift for aub&ftionsiIeW projects <br /> COMMERCIAL (3)complete Sato of Bupft Plane ptue a ufa,Safety Page;(1)set or Energy Facers.RAW Parmn for FOW conStrud0n. <br /> n1murn ton(10)wor"days after submftW date. Required onsita,Construction Flans,Storrnwater Plano w/Sot Fence Instew. <br /> fy FacUlties&I dumpster.Site Work Permft for Sit now projects.Ad commemidi requlmMWft must most CIDIV01161108 <br /> SIGN PERMIT (2)sets of EngInserad Plans. <br /> FRODERTY SURVEY required for ad NEW constmefion. <br /> .. . . . . . . . . . . . . . . . . . . . . . . . . . <br /> Fill out appEcal)n comptemy. <br /> Owner Caft aw sign bads ofe;0cation,notarized <br /> ff aver$2600. NotlesofCommencernsidisrequired. (AlC uporades om$7ND) <br /> Agent(forthe4 xftctw)or Power of Aftmy(for the owner)would become"with notarlmd tatter from after authortzing same <br /> OVER THE COUNrl ER PERMITTING (Front afAppkabnO*) <br /> RervebtfshInglas Sewers Senrice Upgrades A/C Fenca(Plot/Survey/Fooltoge) <br /> DrIvearsys-No over Counter Hon public roaftwp-needs ROW <br />