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a�saao-oozo C;ity ot�ephyrhii�s Nermit App�ication Fax-t313-7ttU-UU21 <br /> Building Department <br /> Date Received `'. �-�7/ phone Contact for Permittin - � � <br /> Owner's Name � Owner Phone Number - d34 <br /> Owner's Address � �� I' ` 1 s�l Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS J` 2- � r . � �3� 7� LOT# �3a <br /> SUBDIVISION � . PARCEL ID# � + ' a0 4 � D • O <br /> (OBTAINED FROAA PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR 8 ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK I � � � G Rt �� � p <br /> �r � �� !�-sa� <br /> BUILDING SIZE {i D O ��- SQ FOOTAGE � HEIGHT <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> S" pp.o 0 <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � / `�2.(_ <br /> t Y� <br /> QMECHANICAL � VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING �] SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> Address ' License# �— <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address License# r— <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y 1 N � <br /> Address License# —� <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y N PEE CURRE� I N <br /> Address Ucense# <br /> OTHER � � , COMPANY <br /> SIGNATURE REGISTERED / N FEE CURRE� /N <br /> Address O c�j�' ` � License# CC��32 ��O S� <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Sitt Fence instailed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdlvisions/large projects <br /> COMMERCIAL Attach(3)compiete sets of Building Plans p�us a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)�Working deys'after subqiittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary�Fa'e�MiUeS$1 durhpster.31idGlfor`k Pennit for all new projects.All commercial requirements must meet wmpliance <br /> SIGN PERMIT Attach(2)se�s of Hngineered Plans. <br /> ""PROPERfY 8lIRVEY re40ired for el!?JLaW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Confractor sign back of applfcation,notarized <br /> If over;2500,a Notice of Commencement is required. (A!C upgrades over 57500) <br /> *" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER TNE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />