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813-780.0020 City of Zephyrhiiis Permit AppiiCation Fax�13 TI OO21 <br /> Suldfng Department <br /> Date Received 1?bona Contort for Paunittt <br /> Ownntb Nama Owtwf Phone Number <br /> Olwnvls Address Owner phone Number <br /> FooSimpia Tltlsholdsr No a Owner Phan Number F- — <br /> I <br /> t aeSlltipIlt T(t(911o(�tr Alt. r <br /> JOSADDRE89 LOT <br /> sly '..._-:—p l"l <br /> Susowletam <br /> d PARCELID1 <br /> WWAM PROSt'1taPOM 71X W1IRGI <br /> WORK PROPOSED Ncw coNSTR B AoomLT ❑ SIGN © ❑ DEMOLISH <br /> -INSTALL REPAIR <br /> PROPOSED USE ❑ SFR ❑ Comm ❑ OTHER - <br /> I <br /> TYPE OF CONSTRIICr(O I {,� BLOCK ❑ FRAME Q STEEL ❑ �_.—�—�� <br /> DESCRIPTION OF WORK <br /> BUILDING Grza SQ FOOTAGE HEIGHT <br /> ❑9UlLDlNG I.—�. VALUATION OF TOTAL cohi RUCTION <br /> [:3mcTRICAL 6 AMP SS32WICE ❑ PROGREss ErimGy ❑ wR.f_.C. <br /> ALittk9lNG S „� <br /> ❑MECHANICAL S VALUATION OF MECHANICAL INSTALLATION <br /> ❑OAS ❑ ROOFING ❑ SPECIALTY= 0'IT W <br /> FINISHED FLOOR FlliVP rfONS FLOOD ZONE AREA ❑YES NO <br /> SUILBER COMPANY i I <br /> SIGNATURE REOISTEFEo I YI N FEECURRM <br /> Address .'�Lkensa t!F <br /> (� <br /> ELECTRICIAN COMPANY I I <br /> SIGNATURE RE,0111111 flO I Y1-N FEECUARD YIN <br /> Address LloenseY <br /> PLUMBER COMPAW =,%M cov— ^t} <br /> SIGNATURE RECISTEM IY/ <br /> �1 "�— <br /> Address l Liesn"5 <br /> MECHANICAL COMPANY i <br /> sacn,ATUan nGacTtfP.D T1 ri I ftCWRlt6P Y N <br /> Address License#1 <br /> OTHER COMPANY <br /> SIGNATURE ^fttEG13TTMO I YINTOCU tRM <br /> Address I License C�� <br /> lltilt/attar'tttlttltitttltlltttlttltlltitl�ttlttltll'1tt11ttlttltltll <br /> RESIDENTIAL Attach 2)Plot Plum-,(2)seta of 9uading Plana;(1)oot of Energy Forms;R O-W Permit for naw Cant Ilion, <br /> MI ten(1O)viWng days after submittal We. Required Onslto,Conawebdn Plans.Stormvralerftno w)Sat Fares Instated, <br /> Sunitim r Factitlee 61 dumpater.Site Work Permit for attbdlvtsionallargv projects <br /> COMMERCIAL AtW,;h complete acts of 9unding Plana Pius a We Solely Page;(1)act of Energy Forma.R-O-W Permit for newtenstmetton. <br /> ,Mtfdm,n ten(10)working doya after cubmntat date, Required o nolle,cons W coon Piano,Sum"AlorPlans wr Sal Few*insLtsdr <br /> Bonito, FOCBitlea 61 dumpster.Silo Walk Pennll for all new projects.All commercial toquIramonle must most compliance <br /> SIGN PERMIT Allwh 2)ndt4 Of E0g9111M Pl9lts. <br /> )PERTY SURVEY required forall NEW construction <br /> Directions: <br /> Fis.cutapphcadonim lataty_ <br /> Owner 4 Contractor i 4n book of application,notarized <br /> n over tr'2as0,o Rati,o of Commememont le raquirod. tAIC upgnados ovor$7000) <br /> Agent(forth*rant aq Or Fewer ct AIMM(for me avlu:t)Vroufd 0e SOmea113 V=notarized letter from owner authorizing u n <br /> OVER THECOUNTERP RMITTlNti (copyCiContractra4tsjred} <br /> Rmli(f angles S Nant StMo L"ludso A/C Fences(PlotSvey/Footage) <br /> Dtivoways-Nol dater .ounter lion public roadways.,nuedo ROW <br /> i <br />