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t . e��-�so-oozo City of Zephyrhill;Permit Application F�-8���6�-W2� <br /> Building Department <br /> Date Recciived �� v�'� Phone Corrtact for Permitting — � <br /> v..��»�: . . < i s__�_� <br /> Owners Name^' � ! (7� ��5 Owner Phooe Number <br /> Owner'S Address 3 '3 5 ���� �, 2 Owner Phone Numbar�� <br /> Fee Simple TkleFwlder Name ►� �/'� Owner Phone Number�--� <br /> Fes Simpte Titleholder Address � ��� � <br /> JOB ADDRESS �� �� + h �. � �T�l� Ii p a LOT# �� <br /> SUBDIVISION � ,1 (G 7 '�5 C D� � PARCEL IDtf D 3 --�L- � /�00/d .—�G�..f,t9 °' b� �� <br /> (OBTAINED FROM PROPERTY TAX N0710E) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT Q SIGN �� MOVE Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR �� COMM Q OTHER --� <br /> TYPE OF CONSTRUCTION Q BLOCK FRAME Q STEEL � OTHER�--� <br /> DESCRIPT70N OF WORK .V—'-C I q.tH r H 4, t /K C1LcH1�����;��F . t � S <br /> 3� p � �i t/ ���, - <br /> BUILDING SIZE SQ FOOTAGE �p�0�O d NEIGHT ' Y ��� r � <br /> � BUIIDING $ <br /> 9SQ• v(' VALUATION OF TOTAL CONSTRUCTION <br /> �� ELECTRICAL �$�O. Q 0 AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> � <br /> � PLUMBING ($� ��� <br /> MECHANICAL I$ VAIUATION OF MECHANICAL INSTALLATION / <br /> �` <br /> � GAS � ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES �NO <br /> � <br /> BUILDER COMPQNY � —� <br /> SIGNATURE �c,� � Y/ N FEE CURRENT Y/N <br /> Address License S �� <br /> ELECTRIGAN ��/�"1 1-5 <br /> / 7y-��q n i <br /> SIGNATURE a�.� I� COMPANY 'k" ' —=J �r�✓ <br /> REGISTERED Y/ N FEE CURRENT Y!N <br /> Address I.t �--e,d Q..t,c�e- ,Jn�-�er� �L License# �'S- l•2 doo 5(o lo <br /> PIUMBER COMPANY —� <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y!N <br /> Address License# �--� <br /> MECHANICAL COMPANY � --� <br /> SIGNATURE is�RED Y/ N FEE Curt�rrr Y I N <br /> Addresa License# �—�� <br /> OTHER /.J x�L J COMPANY ��� •t WYY�CL��t3 L�d v � <br /> �����. <br /> SIGNATURE �'�'sV�-'� REGISTERED Y! N Fee cuit�rrr Y;N <br /> ANdress FI�? 1"1'�� tlYl�1n ucense# 1,�5- 1�.D L�J `J L <br /> RESIDENTIAL Attach(2)Piot plans;(2)sets of Building Plans;(7)set of Energy Fortns;R-O-W Permit for new construction, <br /> Minimum ten(10)waking days aTter submittal date. Required onsite,Construcllon Plans,Stortrnvater Plans w/Sitt Fence installed, <br /> Sanftary Faalities 8 1 dumpster;Site Wark Pertnit for subdivisionsllarge projects <br /> COMMERCIAL Attach(3)complete sets M BuOding Plans plus e LiFe Safely Page;(1)set of Energy Fortns.R-O-W Permit for new constructlon. <br /> Minirrwm ten(10)working days after submittal date. Required onsite,Construcfion Plans,Stormwater Plans w/Sik Fence instaUed, <br /> Sanitary Facilitles&1 dumpster Site Work Permit tor aN new projects.All commeraai requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractw sign back of application,notarized <br /> If over 52500,a Nodce of Commencement is required. (A!C upgrades over E5000) <br /> "" Agent(for the contrador)or Power of Attomey(for the owner)wouid be someone with notariaed letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences(PIOUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />