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City of Zephyrhiils Permit Application Fax=819-780-0021 <br /> Building Department <br /> Date Received �l "" r,, �kosr <br /> Phone Contact for Permitting <br /> (�. <br /> Owner's Name + t ,-. ry Owner Phone,Number L/d, . fJ <br /> I �Q i e c ,r ,., <br /> owner's Address � T���1�c J� '� Owner Phone Number <br /> Fee Simple Titiehaider.Name .-rr: Owner Phone Number <br /> FeeSimple Titleholder Address <br /> JOB ADDRESS Q t LOT# <br /> SUBDIVISION L:>�`( C�� PAR GEL ID# - <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> NORK PROPOSED NEW.CONSTR 8ADD/ALT <br /> SIGN DEMOLISH <br /> INSTALL REPAIR <br /> 'ROPOSED USE SF 0 COMM OTHER <br /> TYPE OF CONSTRUCTION BLOCK FRAME I i STEEL <br /> )ESGRIPTiON OF WORK <br /> 3UILDING SIZE SQ FOOTAGE l$ZZ �� HEIGHT [� <br /> TY-r—r-r— <br /> BUiLD(NG $ l Oct) VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $, r1 ) Q AMP SERVICE PROGRESS ENERGY 0 . W.R.E.C. <br /> =PLUMBING <br /> =MECHANICAL $ C31 VALUATION OF MECHANICAL INSTALLATION . <br /> =GAS ROOFING SPECIALTY OTHER <br /> =1NISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO <br /> ➢-C-C--¢-.-➢-t-➢-1'-➢--i-i-t' -€-a�-i-➢-i--➢-l�--C-�^�'C�6-I-:--➢-➢-x--➢--v-➢-Pei 4-1-�.-3-,4-:-'�. -➢-1-�-➢-tee- "t- ➢�1-�v° �"- --i-➢--➢-➢-I- <br /> 3UILDER .y ` COMPANY - -�0" -e� -`' ��' <br /> PGNATURE — REGISTERED Y/ N FEE CURREN Y/N <br /> Address /r��'�O,�l l� ��<e�t'� ,t r^ � ��� License# a-.Bc o-5 �' I <br /> °LEC(RICIA(9 5. " COMPANY �d1neaJ-a lec-lre C <br /> iIGNATURE w REGISTERED Y/ N FEE CURREN YJN <br /> Address � �J =�x �°� �r?' License# t4 1J f�c^' e4p <br /> Y <br /> )LUMBER COMPANY if.,-a'"17,fa1e <br /> UGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# c�rc r/, <br /> IIECHANICAL 0 COMPANY <br /> i1GNAl`UR C "" "--- -REGISTERED Y'�J N FEE CURREN Y J N <br /> Address ` n?i2 G s ��r�" *� 1r°c�sa c'tr/."�� a�j` License# �i- tt aF;366 1' <br /> ..- - COMPANY ��� •tdi= /�/`� ' -.�F . <br /> )THER "ti /l <br /> HGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address`�r, lt� rEh ! <br /> ---- License# <br /> ➢ ➢ ➢ t ➢ ii6 ➢ 1111i ➢ ti � ➢ ➢ ttiilitllllil- Ili ➢ ➢ Iltllllii11I1 ➢ 1i1It ➢ Itl ➢ i19 ➢ ➢ <br /> IESIDENTiAL Attach(2)Plot Plan ; (2)sets of Building Plans; (1)set of Energy Forms; R-o-W Permit for new construction, <br /> Minimum ten (10)v lurking days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt"Fence installed, <br /> Sanitary Facilities b 1 dumpster;Site Work'Permit for subdivisions/large projects <br /> ,OMMERCIAL Attach (2)completf.5efs of Building Plans plus a Life Safety Page; (1)set of Energy Forms. R-O-W Permit for new•constructlon. <br /> Minimum ten (10)%:)rking 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.All commercial requirements must meet compliance <br /> dGN PERMIT Attach(2)sets of E igineered Plans. <br /> "PROPERTY'SI:•gVEY required for all NEW construction. <br /> I-t-.l.-tl.-6..W..l..➢-.➢.-f.-'�--1--,-C...'r .�.)�{..E-.t4-6-i.-6-➢®@..71...d-il-✓Z-R-Pe➢- -B--B�-➢- •-t-➢'-1- .-i.-)4- -8-Q- l-ds.-I..P-.t-➢eP -➢eB. 6�.-11-.8,. . <br /> Iirections: <br /> Fill out application completely. <br /> Owner&Contractor sign back of ')plication,notarized <br /> If.over$2500,a Notice of Comn oncement is required. (A/C upgrades over$7500) <br /> Agent(far the*contractor)or Pow( of Attorney(forthe owner)would be someone with notarized letter from owner authorizing same <br /> 1VER THE COUNTER PERMITTING (copy of contract required) <br /> eroofs•if shingles • Sewers :iervice Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on pubiic roadways..needs ROW <br />