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A13-780-0020 '"City of Zephyrhilis Permit Application Fax spa-Tao-0021
<br /> Building Department
<br /> Date Received - r -�I ,[ - . . .:. ... .:,=, �
<br /> �+� /M.
<br /> 2/:�� Phone Cbntact�forPermittin !J 6
<br /> ,. (}ram
<br /> Owner's blame" �L C 14"C�- Owner Phone Number �� "mil J ' ��7-33
<br /> Owner's C�"Address . /(Q 3v2 A,V AvA717. (� . Ow"ner,,Phone Number
<br /> �} _ ,
<br /> Fee Simple'Titleholder Neme Owner Phone Number
<br /> FeeSimp{"Titleholder Address
<br /> JOB ADDRESS S� LOT#
<br /> t _
<br /> SUBDIVISipPt. { PARCEL ID#,
<br /> I' (OBTAINED FROM PROPERTY:TAX NOTICE)
<br /> WORK PF,OPOSED NEw.CONSTR ADDIALT SIGN "Q .. Q DEMOLISH
<br /> INSTALL. REPAIR
<br /> PROPOSED;.USE: 0 SFR [ COMM Q OTHER.>"
<br /> TYPEOF CONSTRUCTION.: BLOCK Q. " FRAME �. STEEL
<br /> DESCRIPTION"Of WORK
<br /> r; -71 .
<br /> BwIloil is SlZE'" SgFbOTAo> . /$ � IfEIGFIT lj .
<br /> =tBU1LDING _ $ VALUATION'OF TOTAL.CONSTRUCTION
<br /> =ELECTRICAL $ . AMP SERVICE 0. PROGRESS ENERGY Q W.R,E.C.'
<br /> =,4ECHANICAL $ VALUATION OF MECHANICAL INSTALLATION l
<br /> =GAS ROOFING _ SPECIALTY. Q•. OTHER
<br /> FINISHER
<br /> DI FLOOR ELEVATIONS _ FLOOD ZONE AREA =Y.ES NO
<br /> BUILDER!;, �j E„ 'l Cot1tPANY C-G�G�
<br /> SIGNATURE j/ REGISTERED Y'/ N FEECURREN
<br /> Address Zicense:#`
<br /> =ELECTId[GIAN :COMPANY
<br /> `SIGNATURE REGISTERED Y/ N FEE%CURREM " Y/N'
<br /> ;ta Address,. {:icense
<br /> RLU.{4I46t i
<br /> i 'SIGNATURE"' 'REGISTERED Y•/'N, FEE CURREN Y/N
<br /> Ys Address iacense'.# F_. °.. ._.
<br /> MECHAN1t:AAL"' " .COMPANY
<br /> +`'SIGNATURE:° REGISTERED Y/•N EEE;C.URREh.
<br /> F
<br /> Adr3Pptas�>::. licenSe.#
<br /> a'':".�IGNIATURE:y.i: *' r REGISTERED Y/,N FEE=CURREA Y/N
<br /> I„L „ ,,.f
<br /> Aiiclress:ac, .:Ps. a�;si='<f: License
<br /> t" 1
<br /> : ....-'L ...�...,. K .'-� '.::-: .:j::a'•�'+ • --.•:Jif"':Y.}�i...7,♦..Y::_R�•,�.,..a.,�., r-(.'-§$::.X'�i�F:.:� 4 "4�$h:.�,t:;ate.:'_
<br /> Rli I-iTl�� , :,Atta_ ;'P)dfVlansr..2 setsat�Build1 ;Plans;+:1<setofEri -Foyrris R V:P.ermlt.far•"'riew:i instttiction�.;.
<br /> - „ A;r.,.. Minimum teri x70,swo._1 a afterxsi gin(ttal;date._�Re afred"onsite ConSUu'cti6ir'Plan`s'Stc. water;Plans w/SIlt Fence.lhstalled,
<br /> = ^yx�. .:ai+', r�.._ -
<br /> >> Sal, acilities;&!'A',d m to:„S'e{Nafonlc Peimit fbt si�tidivisiciris/fa. e;"'ro sets ;'r:.
<br /> EO MERCIi41. AttacEt?(2, coiitpiete=sefs±of Bun Ling Fiatis'plus'a"Life`Safety Page,`{1)set of Energy Forms.R-O-W Permit for'neW construction.,
<br /> s,ub
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence.installed, .
<br /> -- Sapltary:Facilities"&:1 dumpster.Site Wotk,Permit;foi ofi,eW,0fgf s;'Rii-i ommerciai requirements:mustmeetcompiiance
<br /> $1Gi1'ERtdIT `"Atfac ()'sets of Engris�reil�t?ians:;:3::,t
<br /> t: ""PROPERTY"SURVEY requlred,for:all,NEW canstralcUon....
<br /> t,
<br /> . =Flll<flut;applicat(on.completely.
<br /> . ttvirner4,'Contractorslgn:back�of'aPp)Icatlon,notarized
<br /> `af-pver;$2300;_a N.otice:;of Commencement.is required. (AIC upgrades over$7500)
<br /> Ag�nt`(for'the ciiritractor:)br t?owerrof Atttimep(for ttie'owrier)'+nrdbl&66`someone with notarized letter from owner authorizing same
<br /> d)OVER
<br /> ' ff IE;CQUN EEt PE'R)iAtT1INC',." ,-.„(copyaof contiairt regwire
<br /> Rerggfs if'sfifrigles 'Sewers" "Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> ,R..
<br /> Dalveways-Not over�Counterif onJpublic�roailways::riee'cis'ROW'" .
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