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Feb.17.2030 01:39 PM A BARTLETT ROOFING OF CEN 18137801805 PAGE. 1/ 1
<br /> 'Bi8.780 0020' ICO of'ZephyrhiNs Permit Applicatlon 1`0-813-780.0021
<br /> •Buuding Oeparoneht
<br /> RateRecetved Phone ConlaclforPannktin� -SS
<br /> Ovmer'e.Name ' ' '9!�erPHoRo'Nlrmbel�',:J"";,, '�''(d•,
<br /> owner's AddrluR G7 Z,,OK+ttpr,Phone Number
<br /> Fee Simple Titleholder Name ": Owner P►iotie Numper '.! .. W I
<br /> PoetRmpleTltta)ioldsr'tiddreee .. •.. :,: �'
<br /> .IOB ADpm"ii8 LOT Al
<br /> SUBDIIIISiON PARCEL 00 �' !
<br /> . . .. . ,. ... ,:+• .,• ,10P,1111NBRM:RMt;ROPPRIYTAXNA'lIC,6)
<br /> WORK PROPQ8E0 ;.l NSW COrtSTR ADD/ALT :'.SIGN.. 'A''• ] DEMOLISH
<br /> o INSTALL• REPAIR
<br /> PROQASWUBE Q.. ..,SF.R•. �]., Co.AM [��,� •_OTHER•:
<br /> TYPE OFdONS,TRUCTIOtJ SLOGK'
<br /> DE8CRIRTION OF WORK. /
<br /> BUILOI�fO SfZt St2 FOOTAGE Q8 NEWT !
<br /> -rrtt'rs'x-c+tt'ss'�•s's'�•a-s°>�!s�-cr�-ccs•, r -cE,r"ft=Es=rcr
<br /> BUILDING-' 1 �/ + �•°i1' VALaf ioN OF TOTAL CONSTRUCTION
<br /> r-JgLE�TRIC!AL S ,,, , r;: ., ANIRi3�iil�iCE, C]• P,ROORESS ENERGY,. ;M. W.RE,C.
<br /> •i
<br /> QPLUMBING $ "
<br /> [MMECNANICAL S VALUATION OF MEQHAmcAL M31'ALLA'ndN;
<br /> ft00FItSG. SPECIALTY, (MNER •r,
<br /> FNISNEO FLOOR ELEVATKIN8 FLOOD ZONE AREA Miss • "•'NO•'•
<br /> BUiLpER�- - ---------- - - .. � �COMRANYu !� +� • � • • �� -f��fJtQE'S
<br /> SICj1ATURE REGISTERED• Y IT' •-•;',PEEcurjRE, Y N.-
<br /> Address ,. ¢, ;, Llcgnse#�. f�J+3' � 9
<br /> ELEOTRICIAN'• 'COMPANY !
<br /> SIGNATURE I YIN
<br /> FEHC1rRRHN J Y
<br /> Addneio
<br /> PLUMBER COMPANY --�_�--�—
<br /> SIGNATURE FtRGIBYERW I ._+4J FEECUnNEN.- . IN
<br /> AUdresi' ' 'Li6tMbf{
<br /> MECHANICAL COMPANY :'+
<br /> SIGNATURE R'E01MR.Eo LILN FEeoU(R�RH'N'`''" Y I Nr
<br /> Address �LlcelmoS I
<br /> OTHER v COMPANY
<br /> SIGNATURE REGISTERED I Y/N FEE QWWN Y 1
<br /> Ad*m Llaenae f►
<br /> alaaaaalaa sage aalaiaaaa Igloo 88oleateG88tiaesse 8lalaaHBa[Ber8aillNAPAAA..
<br /> RESIDENTIAL. Attach(2)Prot Plenty(2)sera of Bonding Piano;(1j'ist df Erieigy Forma;ROAN Permltfor new Construction, "
<br /> Minimum tan(10)wroddng days after submrilel date.Required wafts,Constructlon Plans,Stormwater Plena w/Silt Fence Installed,
<br /> -Senftery FaclHtles 81 dpmpetpr,$Its Work Parma fpr eubdlvNionellarge pro)ecls
<br /> COMMERCIAL Attach(2)complete sets of Buliding Plena plus d Llfe SaW Page;(1)set of Energy Forme.R-O-W Permit for now construetIm.
<br /> Minimum tan(10)wofking days after oubrrtittet date.Required onff te,Construallon Plans.Stormwater Plane w/Slit Fence Installed,
<br /> Sanitary Feoilltles 8,1 dumpster.Site Work Permit for all new projects,All commerdal requirements must meal oomptlance
<br /> SIGN PERMIT Attach(2)aetn of Englnesred Plana.
<br /> *PROPERTY SURVEY requlmd for all NEW construction.
<br /> Dlrec c"
<br /> e Go Go 66 as Go
<br /> Fin out apolkwPon completely.
<br /> Owner 6 Contractor sign back of eppiloation,notarized
<br /> If over$=0,a Notice of Comrnencement Is required,(AIC upgrades over$7100)
<br /> °• Agent(for the contractor)or Power of Aftomey(for the,owner)would be someone with notarized totter from owner euthorwria same
<br /> OVER THE COUNTER PERMITTING (copy of contract required)
<br /> RM00%Iehingtes Sewers Service Upgrades A/C Fences(PlonwaylPootage)
<br /> Driveways-Not over Counter If on public roadways-needs ROW
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