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06/23/2011 13:20 3525674454 MILBAR PAGE 10/14 <br /> " Ciry of Zephyrl7iNs Permlt Applicafion Fax.a <br /> Building.Department �,33s <br /> Dnto Recolved ' <br /> PFIOn� Cqr�ct for Psrmitqn <br /> �or's Name , � <br /> Oww1x Phen� Numbrr 14• / 3 <br /> Owner's Apdrers <br /> Owner Phone Number <br /> Fee Slmple 77tleholder Nama � <br /> --�--• __ Own�r Phons Number � <br /> Fee Simple TiNeholderAddress �( �� <br /> JOB ADDRQ$S •� r k . Z , � <br /> LOT 1� <br /> SUBDIVISlON � �'1 , PARCEL IDqM � <br /> (OBTAMIED RItOM pRpplpTy TpJ� NOTICE) ` <br /> WORK PROpO3ED e NEW CONSTR [� ADDIAI.T � SIGN Q MOVE � DENIOIISH � <br /> INSTALL U REPAIR -7 � <br /> pROP05ED USE � SFR Q COMM � p�}{E�q ���.---, ���y / �% <br /> TYPE OF CONSTRUCTION Q BLOGK � FRAME Q S'I'�E� Q OTHER <br /> OESCRIpT10N OF WORK <br /> BUILD(NC� $I,Z6 $Q FOOTAGE NEIGHT <br /> Q� BUII.DIN� S / 7� y 7 � � VALUATION OF TOTAL CONSTRUC710N <br /> v � <br /> Q ELECTRICAL :� AMP SERVICE Q PROGRESS ENERGY 0 w,R.�,a <br /> �„_] PLUMBING �� � <br /> Q MECHANIC/A� $ VALUATION OF �IECHANICAL INSTALLA�'ION j� <br /> j <br /> �. <br /> � G�S Q ROOFING Q SPECIAL.TY Q OTNER <br /> 1=1NISHEO FLOOR ELEVATIONS FLOOD ZONE AREA QYES �NO <br /> i ry�, (� <br /> BUILGER COWPANY 1 � I11. �� .1l l}L14'Lfer._, M` <br /> SIGNATUR� RR.G187E�ED N I�I[� CIHt Y N I <br /> AddrOSS ���� � �� �Q G �� a .� (,Ir�se# �,�,�, 1'�,`��� . <br /> �LECTRICIAN � � COIYIPANY �— <br /> SI6NATURH REGISTEItED Y/ N i FEE CURREIJT Y! N <br /> Address l,leerwe t� <br /> P�UMBER � � COMPANY <br /> SIGNATURE neas�Reo Y! N i FEE CLIRRENT Y! N <br /> Address Llcense # I <br /> MECHANICA'L � � COMPANY <br /> 3NATURE REA197ERED Y! N FEE Cu1tRENr Y! N <br /> Addross L,loense # � <br /> OTMER COMPANY � <br /> SI(iiJA i UR'e " REGI3TER'cC Y 1 N FC£ CUR�?5NT Y/ N <br /> Adtlross I.�wnse # �� <br /> RESIDEN7IAL AtteCh (2) Pbl Plans; (2) set8 of 8ulldin9 PIlx�s; (1) sM M Enerpy forma <br /> Minimum t@n (t0) w�rking deys after aubmiMal dats, Roqulred onsite, Conatnrction Plaha, SanNary FacilRias 81 dumpsfer <br /> COAMNERCIAI, Altoeh (3) sels of 6uilding Plans; (1) aet of Ene�yy Forms, <br /> Mlnimum len (10) wo�lcinp days aftar submltfal date. Repulred onalta, Construethn Plans,,SanNary FacllHlas 81 tlumpster <br /> All commarctal roquMements must meet compllance. <br /> SIGN PERMIT Attach (2) 68tS ot Eng11190rod PIah,4. <br /> """PROPER7Y SURVEY required for sll NI�W construction. � <br /> rocNona; <br /> Fill oul eppllcation comptetely, <br /> Ownor 6 Centroetor sfgn back M app0eatbn, netarizetl <br /> If ovsr Z2500, a Notico ot Commoncemaik l8 roquired. (A!C upgrpde9 ovor S5000� <br /> '" Ayent (to� Me tonMador) or Powe� Of Adomey (for-4he own9r) would be someone witfi natarized IeUO► from owner authoHZing aame <br /> OVER THE COUNTER PERMtTTING (Front of Application Ony) a <br /> Reroofs Seweis Servk,e UpgraQes NC Fences (PIoUSuNey/Footage) <br /> Drlvewayx over Couritar ii on p�l� roadways..needs ROW ° <br />