813-780.0020 City.of:Zephyrhilis'Permit:Application Fax413-780.0021'
<br /> Building:Depaflment _ .
<br /> :Phone,.Coptaet;for'P®rinittin
<br /> ::•Own . . Nam rn ��;GwneK:plioi�`�iumb§r. •Z:�>. :Z �Q::.:
<br /> Owner'ti=
<br /> Adaresg
<br /> �,OuVrisr<PN�rr��Numbe't
<br /> duiir"r>ah onbs mti®f"
<br /> - .ti ,r� ,:k": .t:' ::ice•' '1::LCT' .�"�
<br /> ;StJBD11lISION: . PARCELIDl�' �
<br /> - - r-,
<br /> -: ..•f :._,: .-,. ;.-. . ....r..; ROIVIxP.RQP,; rQTI g).l;.��.
<br /> ::;`(bBTAIHED� �'LtT16'tAX;
<br /> W POS pROEb•. �a.r.''
<br /> - _ :'NEWCONS.7tt '},.• :'ADD/ALT.;�•t:-. :-SrGN' - :�
<br /> NS1'ALLi: :aft',p A
<br /> ,
<br /> :o.
<br /> p �.;.
<br /> R P O OS D:US -r:
<br /> ... -.rC.OMM�'.;. O'TIER�s `
<br /> S ••yy
<br /> -
<br /> RU�`TION�'' •BLOCK :F Ri41iAE: ''S'1?EEf"�`
<br /> ''DESf21pTI0I 0i=1N3RIG'' i
<br /> :BUILDING.SIZE i S [FOOT Gi�
<br /> - �`l. �.J.ko•:i}'Si:,:>=r•':,
<br /> t l-, _
<br /> ci
<br /> ,
<br /> VALUAtION.01=7<TAIs' NS7�tU N.
<br /> _ „ . o co Crl .,.
<br /> E'E RCA AMt?'SERVICE. DUKE}ENERGY, .E:C:.
<br /> =MECHANICAL $: VALUATIONOFMECHANI�-,.i4L'INSTALIAT,ION
<br /> =GAS -ROOFING.: SPEOIAI TY; ..OTHER:.
<br /> F fix, :: ..
<br /> WISHED FL'OOR;ELEVATIONS:: �' aFLOC1p..,ZbNE;�tREA .":`-" '`tS=.
<br /> BUILD COMPANY,.. awl-Q? ;.-
<br /> SIGNAT RE .:;: _.;:REG�s'TEREO:
<br /> 41'
<br /> Address
<br /> ELECTRICIAN' :COMPANY; t:.•+t-'
<br /> SIGNATURE� _ _ `aEcisf�ROq�' _ ;� Y;i/;a1t•".' ': .,c�..FEE;Cl/RREt ;-:.
<br /> Address-
<br /> P:LIjMBR :.COMf'tiidNX"
<br /> SIGNATURE :t,;.i �
<br /> � �YA%FI�I
<br /> MECHANICAL _COMPi4flY' s:
<br /> - ','
<br /> :'1sC
<br /> ,,,,...
<br /> dde„
<br /> E'1't LD` xYr c?Nc ;;r: E'EURREN`'
<br /> SIGNAYU�E'. :R cs,Ea - / .,. ,,
<br /> ::Adages :....
<br /> .} �. :{: ,fix, ti. >.,R ., :v. 'o.` - = :-�,,• _ -
<br /> i a t tNvR' a"YaccrisN o
<br /> f `id 'PI����' 1 e'e:oftEti +iir'n's'�. e"` �fol�^i� '•c�tt ;N... ..�t: -
<br /> RS�IGE�IYIAi: d.�1 t ,.�(.) .t9 _ ,,�- ►1+. 1A;. .c ,.`,`• ,yJJ ark,,
<br /> �4,51:",+'(?K jA.^•1'i.�lat 7 I ��� ?P_ i' 't .l :
<br /> f
<br /> r i;f•' �r
<br /> YC
<br /> ..
<br /> u
<br /> nAllinPiFiudrteA=�A)�Ark:tig.da�is;a�ter's� late.,tq�6'ite�ogslt�:�'Con�otibti�� ns;SSjor��`aCe�. '.�,
<br /> Sanitary Facilities B tJumpst�r Sit W,6tk�Peit►lit'ftir sutididtsltin3/IWd,projeEts`
<br /> COMMERCIAL Attach:.(2)co�itplete,s8ts,o�ei�l(dpgt?Ians; Ris':a�: : fPaigA,'(7j'$eY`oftErtergy.Fo'rrns;R-tW Renriitforriewrgtisquctlon•,,.,
<br /> MlNmum=tBM,(10);wgikin �doy, a ergs lei ffel tla"is tB R ' ;'.i�nsite ConsGvcti0.44g"ns�,Stormv(etbri 'i n yV% IltrFeilCer irl taller:
<br /> Sarittary:Faollities 8 1_lluili ter I�eW.)WOim'106k A new?leots:Alf:coinmer eL`.eauCrer`n nts`mu�t'nteef compl(anre':':;
<br /> "'SIGN PERMIT'' AttabFi(2)' etsrofaEngin'eeredrPlariS:r:':;«�r:
<br /> H1f 'fir -
<br /> PF20PRT1X�' 'IY:`riequired=fa�alt:'Nt:W`cbfisfruCbion.:,
<br /> Directions:
<br /> Fill out appllca0on completely.
<br /> OwriA' $'66, tor: ign��ack',ofa RliCation;notarized.
<br /> If bv+�rS2 OO a Nof1 ®of Comm®riciinenl;Is requWdr-:(A/C'up&,,4des.over.$7500)
<br /> •• Agent(forlhe contractbi)ortpowe�'of Altomey(ibr:the otiVner)wcutd 6ti`someb�iekwlth`ndtBHgd;letter-from;'awner autlidriiir�g'eame: .
<br /> OVER:TMEa;OUHTER:PERM1TsTING,._ .,.(cgpy,�of co htrareiquired),
<br /> Reroofs if shingles Seweis Seri►i col'Upgra'des'i4lC' I?eh'cas(Plot/Suwey/Fobtage)
<br /> Driveways-Not over Counter if on.public roadways..needs ROW
<br />
|