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813.78D-0020 City of Zephyrhilis pirmit Appil ;aUon <br /> Building Department <br /> bate Received Plunecontact for Pe I lIttin MR _CG ICA <br /> 5: L <br /> Ownefs Name % Owner P one Number <br /> OwnefsAddlml Owner: 110NUmbar I — I <br /> I"Simple Titleholder Name owner no Number <br /> Fee Simple T111oholder Address <br /> JORADDRESS Af.. LOTH C(b <br /> SUBDIVISION PARCM IDO <br /> Cill I <br /> FaaraarsoaERrrrntuNonep <br /> WORK PROPOSED OWC014 ADDIAUr 7= SIG M ❑ DEMOLISH <br /> M Z W ER <br /> INSTALL REPAIR <br /> PROPOSED USE ❑ SFR 71 comm ar ER <br /> AF ST <br /> TYPE OF CONSTRUCTION ❑ BLOOK C) FRAME ST <br /> DESCRIPTION OF WORK L4LA--� <br /> SUMNIG size SQFOOTAG5= HEI FIT <br /> .. . . . . . . low <br /> r—IBUILOING VALUATION OF TOTAL CONIMITR CTION <br /> r--lELSOTRICAL AMP SERVICE PROGRESS ENERGY ❑ w.R.r=.c. <br /> E6`LUMBING <br /> =MECHANICAL 1$ VALMON OF MECHANICAL INSTALLATION <br /> MCA$ M ROOFING M SPECIALTY= OTH-M <br /> FINISHED FLOOR ELEVATIONS — 7— FLOOD ZONE AREA YES NO <br /> - <br /> . .. . .F <br /> . . . . . .... . . . . . . . .. . . . . . <br /> BUILDER: COMPANY <br /> S"TURE 1. yfl.Nj RECURRU LI.LN_j <br /> Address License a <br /> ELECTRICIAN COMPANY I I <br /> SIGNATURE REdieTEAED Y11N I FEECUltlitak <br /> Address Ucmse# <br /> PLUMBER COMPANY <br /> SIC-NATURE REGISTSED MOURF0 YfN <br /> Address <br /> MECHANICAL COMPANY <br /> 'SIGNATURE flEGSIERED I WIN I FEECU11010 YFN <br /> Add -- _I Tu em#Address F <br /> OTIIER COMPANY <br /> SIGNATURE FEGIMED I FHCLRM <br /> Address 7 Uwnse#F— <br /> III oil III I I it IIII III I III III 11111111111 a <br /> 1111111 <br /> RESIDENTIAL Attach(2)Ptot Plan-,(2)sets of Building Plans;(i)WofEnergy ftffw. Pernifitilarnawconstruction, <br /> _R4i'- ." <br /> Minimum ton(10)working days after submittal data. Required onsite,Con n Plans,Stottirwater Plans wif SiltFencelastaled. <br /> -a .1 <br /> Sanitary Facilities&1 dumpster;Site VVb*Patmil for subdivisionsnarge prole <br /> COMMERCIAL. Attach(2)complete ads of Building Plans plus a Life Safety Page;(1)eel of S orgy Forms.R-O-W Permit for now canstruiftm. <br /> �"`uu n'r,j Minimum ton(10)working days after submittal date. Required onsoft�j Plans,StormwaterPiamwfSiltFentainstagett e,0�4="truu n <br /> Sanitary Factfiflas&I dumpater.Site We*Permit(or all new limlects.All com ardal requirements must meet compliance <br /> SIGN PERW Attach(2)sets of Engineered Plane. <br /> **"PROPERTY SURVEY required Wall NEW construction. <br /> . ... . . . . . . . . . . . .. . . . . . . . . . <br /> Di.,tl.ns: <br /> Fig out application completely. <br /> Owner&Contractor sign back of appic0on,noterhmd <br /> ff4v*rft6Q0,*NotlaeofOommoncemontio required. (A(C upgrades over ST600) <br /> Agent(fW the contractor)or Pow of Adonvay OW the cwnW)would Us surneona WWI nolafti 3 letter ftm writer autho(MIng same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reircols If shingles Sawers Service,Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter It an public roadways-needs ROW <br />