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<br />10/31/2007 08:32 <br /> <br />a 13-780.0020 <br /> <br />3525674454 MILBAR <br /> <br />City of zepnymills Permit Application <br />Building Oep~rtmenl <br /> <br /> <br />PAGE 01/05 <br />Fex'O 1 0-700-00Z 1 <br /> <br />C3~~ <br /> <br />Dato Racolvod <br /> <br /> <br />Owner'. ~m. <br />Owner'sAddnlSs I 5'~14 (,.'"^- ~:Y~LA- l"l."'~\\.... <br />Fell Simple llUehold.r Namlll <br /> <br />Ownor Phone Number <br /> <br />Owner Phone Number I <br /> <br />Fee Simple TItIoholder Mdress I <br /> <br />..""',,...... -~;9: l'*'o ~~ -;--:' <br /> <br /> <br />---E.. . f . PARCEL IlJtIl <br /> <br />RE:.Q,.).)"" <br />El NEW CONSTR 0 ADD/ALT <br />INSTAl.L D REPAIR <br /> <br />PROPOSED USE 0 SFR D COMM <br /> <br />TYPE OF CO~TRUCTION D BLOCK' CJ FRAME <br /> <br /> <br />DESCRIPllONOFWORK I ~'h\W1'1.f , KCL~ 3'31l.oo ~ <br /> <br /> <br />BUILDING SIZE 'I sa FGOTAGE I J L ~ <br /> <br /> <br />C2r :;ahV ~/~-I <br /> <br />o ELe'cTRICAL 1$ I <br /> <br />D PLUMBING 1$ I <br /> <br />o MECHANICAL 1$ I <br /> <br />o GAS ~ ROOFING 0 <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />~ I'" '%""1 <br />.- .LOU f~.:l. <br /> <br /> <br />tl- '2:.,",- '2..\ .o.:)\~- Q'2~O~. I"'\\L~ I <br />(OIlTAINEO I'1tOM PR~ERTY TAX NOTICE) <br /> <br />SIGN <br /> <br />o <br /> <br />MOVE <br /> <br />o <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />D <br />D <br />D <br /> <br />OTHER I 'Rt.-ct~':- <br />STEEL 0 OTHER I <br /> <br />R... \,,\q.,.~ .~. ~ l'l.u.... I <br />~ O~. 010'1.'>, I) I <br /> <br />HEIGHT I <br /> <br />VALUATION OF TOTAL CONSTRUCTION. <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.I,:.C. <br /> <br />OTHER <br />DYES <br /> <br />/,./ <br />~~1 <br /> <br />DNO <br /> <br />....~.,.,..,,'" <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br /> <br />VALUATION OF MECHANICAL INSTALI.ATtON <br /> <br /> .. <br />m i Ir.:nr- ~~l1d, ~e., I <br />I tUN \ . FEE CURAIlNT V N <br /> Weense , I Ct'~ ()5/5 U :J.. I. <br /> '1 L.:!.L!:U I <br />YI N I FEE CURRENT <br /> Ucense tI .1 I <br /> I I I V/N I I <br />Y/N FIili CURRENT <br /> L.k:en1l8 ... I I <br /> I Y/N I I <br />Y/N FEE CURRENT <br /> Licente ,. I <br />I'Y IN \V/N I I <br /> FIE CURRENT <br /> License # I <br /> I <br /> <br />BUILDER I- <br />SIGNATURE . <br />Address I J 5q /I U~!3DI <br /> <br />COMPANY <br />REGISTERED <br /> <br />'I.:'ode C;f!),~J a~3 <br />I COMPANY <br />. REGISTERED <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNA 1\JRE <br /> <br />COMPANY <br />MGISTERED <br /> <br />Address <br /> <br />MeCHANICAL. <br />SIGNATURE <br /> <br />COMPANY <br />REGIITlIIll!D <br /> <br />Address <br /> <br />.,. <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />RElllateRED <br /> <br />Address <br /> <br />RESIDEN'nAL <br />COMMERCIAL <br /> <br />Attscl1 (2) Plot Plena; (2) selS of Building Plans; (1) set or Energy Forms <br />MInimum len (10) working deys alter submittal dale. Required onsile, ConslnJctlon Plans, San"ely FaclIlUes.& 1 dumpster <br />Altlch (3) sels of Building Plans; (1) eel of Energy Forms. <br />Minimum len (10) WOrking days after submillBl data. Required onslle, ConslnJction Plans. Sanitary Fecll.llIS & 1 dUlllpsler <br />^" commercllll requirements mUlt meet compaanee. ' <br />Attach (2) selS of Engineered Plens. <br />""""PROPERTY SURVEY required for ell NEW construction. <br />. <br /> <br />SIGN PERMIT <br /> <br /> <br />Dll'ectIons: <br />FII out application completely. <br />0""'1)' & ConllllclOr sig" back of appMcallOn. notar\zl!d <br />It over $1500, I Notice of Commencement Iv required. (AIC UPllI1lde$ over 56000) <br />.. tcii..~~~~ '>.'~0r) ~U/d be soMltonel/lllltt n__ ~,from owner eu\horl2Jng "....... <br /> <br />~,:. ..."., ....... .jlblllill.Qnl'l)'".,,;_:';,'.'.,~::.: ... .. <br />,"':~-!":'?'::";~BiVli:6opgra_ . . ...I>JC f.ilceSl~UNeylf~) <br /> <br />.D~ ""e, COII"''''\' 01\ ",,"lie "'aclw1l>f........as ~OW <br />