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- <br /> 913-760-0020 City Of zaphyri-tills Permit Application Fez sty 780-M21 <br /> Building Dayartmant <br /> Date Rocelved phone tbmact for Per In <br /> Owner's Name It Phone Number <br /> Owners Address OvIner Phone Number <br /> Fos Simple Titleholder Name Owner Phone Number <br /> Fee simple Titleholder Address JOB ADDRESS t r "- as—j LOT <br /> suaOMSION e! PARCELIO#F tornivirsoRtoMPROPERTYTAXWO11104 I <br /> WORK PROPOSED NEW CONSTR ADDIALT SIGN M Q DEMOLISH <br /> P INSTALL REPAIR <br /> PROPOSED USE [Z] SFR ❑ COMM OTHER r............... <br /> TYPE OF CONSTRUCTION 17-7 BLOCK ❑ FRAME STEEL M <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE SOF007AGOE-1 HEIGHT <br /> ff,)UILD ING 1$ VALUATION OF TOTAL CONSTRUCTION <br /> r-1ELECTRICAL AMP SERVICE ❑ PROGRESS ENERGY ❑ W.R.E.C. <br /> 5� PLUMBING ]--X�`%C-0 X:%v"* <br /> -7 <br /> =MECHANICAL VALUATION OF NIECH VICAL INSTALLATION <br /> r7GAS ROOFING ❑ SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AR I A =YES, NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED I YIN FEECUAREI, L_LLN J <br /> Address I License# <br /> ELECTRICIAN COMPANY [ <br /> SIGNATURE I AEcdiOTERED Y1 N FtECURM I YIN <br /> Address Licensect <br /> PLUMEER COMPANY <br /> SIGNATURE 1 aEGrsrEaED FSECUMkB I YIN <br /> Address xu oe ties c L�&�-a-c>v�m <br /> MECHANICAL COMPANY I I <br /> SlIGNATURE n6GCrEflED YIN fmcupio:11 I YIN <br /> Address <br /> OTHER COMPANY E: <br /> SIGNATURERE018TEKI) I Y/N FEE CLMM Ly N L_j <br /> Address LIcerseff <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plow,0)set of SIX Forms;R-O-VV permit for newconstruction, <br /> Minimum ten(10)woming days after submittal date. Required one is,Construction Plans,Stormwater Plans w/Slit Fence Installed, <br /> Sanitary Facilities&I dumpater.Site Wok Permit for sUbdivlslcns large projects <br /> COMMERCIAL Attach(2)complete ads of Building Plans plus a Lire Safety Page,(1)set of Energy Farina.R-O-W Permit for now construction. <br /> Minimum ten 0 0)worlting days after submittal date. Required one to,Construction P14no,Stairmwer Plans w/Sot Foriall Installed, <br /> Genii"Facilities&I dumpster.Site Worit Permit ter all new prof c ots,All commercial requirements must meat compliance <br /> SIGN PERMIT Attach(2)sets of Enolneared Plane. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> . . . . . . . . .. . . . . . . . .. . . . . . . . .. .. . . . . . . . . <br /> Fig out applicadon completely, <br /> Owner&Contractor sign boots of application,notatfaud <br /> lfavor$2600,aN*UreofC*mmonoomontlercquired. (AlCupgrados over ST600) <br /> Agent(for the contractor)at Power of Attorney(for the acme*would be somoono with notortzrA letter from owner authorizing as= <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Retools if shingles Sewers SoMee Upgmdoli At Perot(PlotfSurvc.v!Footage) <br /> Driveways-Not over Counter If on public roaWsys-needs ROW <br />