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ais-�so-oozo City of Zephyrhifls Permit Application Fax•8�3-780-062t <br /> � Buiiding Department <br /> Oate Received :—�'!�� ` Phope C�tact for Parm�C�t�� 2'Z�i �p�. <br /> r � r � � r r_7 . ` r-�-r-r-�-. <br /> Owrter's•Name J�V/ � �F� � /►U S �' Owner P�one Numher � <br /> pwner's Adtlress 1Y�� C OJ�lt�1 W! 31`,g 7C 2� � Q Owrier Phone Number { �[�7 7�./ 7��G � <br /> Pee Simple T�Nebolder Name �— Owner Phone Num6er � <br /> Fee Simp{e TitEeholder Address <br /> J09 ADDRESS F.P ��� i,•;11,;. ��� �1�i� t' LQT# � <br /> susoivisNOr� �/n � PARCEL 1171i � a� v�I OD l0 d l,�0 0 d D l O <br /> �OBTAINEU FROM P(fOPERTY TAJt ttOTiCE) <br /> WORKPROPOSED e wEwconrsrRB ADD/AI.T [� SiGN Q Q [)EMOLiSti <br /> ItdSTALL REPAIR <br /> PROPQSED USE Q SFR Q CQMM � OTHER a °r � <br /> TYPE OF CON5TRUC7ION Q E3LC7CK Q FRAME � S7EEL Q �/A / <br /> DESCRIrT{ON OF WORK C.+'"1` �.:'r: �r�... �✓, t w. ��:tlx'�:'at_',�.. �G.. t`43 � ��`�F)I�.l�., {1 S 4�J <br /> BUILDING S1ZE �� SQ FOOTAGE� NEIGHT � <br /> Q9WLDING S VALUATiQN OF TpTA�CUNSTRl1GTiQN <br /> ELECIRIC:AL g 3o p�� AMP SERVICE O PR(3CrRE55 ENERGY � YJ R[C <br /> OPlUM81NG 5 �" '� <br /> QMECHANICAL $ VALIJATtON OF MECHANICAL INSTALLATION � j��O 1 <br /> QGA5 Q RQpFYNG Q SPECIALTY � OfHER <br /> FINISHEI3 FI�OOR EIEVAT[ONS �� F�OQD ZONE AF?EA �YES N� <br /> BUILOER �p�_y �UM�� �� COMPANY f—' '—N� C�.C� D 7����5-� +1G. <br /> SIGNATURE �Y����' ���� RFG15TFRFD Y f N I E.E CUHRC� Y 1 N <br /> Address License# ���301y 3 37 �T—] <br /> ELECTRICIAN � � ` COMPANY Z�D�� �W QC ✓����5 -�--YC- <br /> SiGNATURE HEr,isiErtt�7 Y( N FFF t:�1RRCP Y�N <br /> Address y1o12 ( W f1 Je �� � � �� ucense it �� � ��//�� <br /> PI.UMBER COMPANY �� <br /> SIGNATURE ttt<;isYtr�eu YI N fi"FCi�F2RfA VtN <br /> Address LicEnse 3i <br /> MEGHAkICA� �� � GOMPANY � <br /> SIGNATURE Hcurv;r[ctt'o —LY 1 N Ftt cuaa[n Y!N <br /> Address License# � T� <br /> OTHER � � COMPANY � � <br /> SIGNATURE � n�s,isnar-o Y! N f-F.E CURNEA Y r N <br /> Address Ucense it �— { <br /> I i t 1 1 1 1 1 1 1 1 1 / 1 1 1 1 1 1 1 1 1 1 1 / 1 1 1 1 1 l t 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 i / 1 1 1 1 1 1 1 1 1 1 <br /> RESIDENTIAL Aflach(2y Pipt P9ans,f2)gets ot Ruitding Pfans.(t)set bf Energy Farms,R-4-W Pem+it(or new consWCt�an, <br /> Minimum ten(10)working days afiet submiftai date, Reqwred ansrte.Ganstruction Pians,5tormwatar Plarts w/Sd1 Fence inst�Ued. <br /> Sanitary Facilities&t dumpster;Srte Work f�ermit fwsubdiwsionstlarge projects <br /> COMMERCIAL Aqach(3)complete sets of Buitding Plans plus a Ufe 5afely Page;(1)set of Energy Fortns.R-O•W PQrmit for new conslruct�on <br /> Minimurn len(1p)wnrkEng days afler submiltal deIe. Required onsite,Conshuction Pians,Stqrtnwster Plans wt Silt Fence installed, <br /> Sanitt�ry Faailities 8 1 dumpster S�te Wwk Permil for ali�ew projects.atl commerc�al requ;rements must meet compliance <br /> SIGN PERMIT Adach(2}sets nf Engmeered Pians. <br /> ""PROPERTY SURVCY requirad for ail NEW consUuc�an <br /> Directions:• <br /> Fiil ou�app6cation completely <br /> pwner 8 Contractor sign back of appLcaUOn,notanzed <br /> tf over$2500,a Notice of Commanoement is required. (A!C upgrades over 3750Uj <br /> " Agent(fhr tho contractnr}or Power ot Attomey(tor the awnerj wouitl be somcone nnth notarized letter trom cmrner euthoriz�ng same <br /> OVER TME COUNTER PERMITTING (Front ot Applicaiiort Only) <br /> Reroofs d shingles Sewers Service Upgrades A/C Fences(PlotlSurvey/Footage) <br /> Driveways-NOt over Counter it on pubt�c roadways needs ROW <br />