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R"-���020 �ity of Zephyrhiiis Permit�ipplication Fa1{?3-780-0021 <br /> Bui!ding D?partment <br /> D'ate Received � � ��`-� <br /> Phone GontaM for Permittin ( � �� S <br /> T��7Tf"Trl" TTT <br /> Owner's Name G ,`1 L Owner Phone Number �13-��O ' �� <br /> Owner's Address!�7 gG'a rl���SS 4 �< <br /> Owner Phone Number <br /> Fee Simple Titleholder Name n�`�G �C��,�„j� J pWner Phane Number � <br /> Fee Simp!e TitleholderAddress �p�7.� iJ}jtj Cl(tI M,� Ug' � <br /> 7 <br /> JOBADDRESS ( A' I/,S,SL. /�r• LOT# �� <br /> SUBDIVISION PARCEL ID#, fS���p-��- 6/70- v��oa <br /> (OBTAINED FROM PROPERTV TAX NOTICEI <br /> WQRK PROPOSED e NEW mNSTR 8 AD�IALT � SlGN Q CI DEMOLISH <br /> iNSTALL REPAIR <br /> PROPOSED USE � SFR � COMM � OTHER <br /> TYPE OF CONSTRUCTION Q B�OCK Q fR,4ME � STEEL C <br /> DESCRIPTIQN OF WORK � <br /> 9UILDING SIZE SQ FOOTAGE� HEIGHT �� <br /> �BUiLDING $ VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRIGAL $ AMP 6ERVIrE � PROGRESS ENERUY � W.R.�.r. <br /> �PLUMBING ($���- � � <br /> �MECHANICAL $ �,„'rA ' 'vHLUi�TION OF MECHANICAL INSTALLATION � ' 3� <br /> ��A� � ROOFING � SPECIALTY � OTHER <br /> F�NISHED FLOUR ELEVATIUNS FLOUD ZONE AREA �YES NO <br /> �- <br /> BUILDER � COMPANY I <br /> SI(;NATURE - REGISTERED Y I N FcE rURRENT Y/N <br /> A�fC33 <br /> L�cense# <br /> ELECTRICIAN � COMPANY <br /> SIGNATURE REGISTERED Y/ N FtE CuRRENT Y I N <br /> Addrsss � <br /> License# <br /> PLUMBER � COMPANY � <br /> SIGNATURE � He�isTC'neo Y/ N FEE CURREN7 Y/N <br /> Address <br /> License# <br /> MECHAMICAL u��y� � 4,y � LVp�� <br /> COMPANY <br /> SIGNATURE � REGISTEREu Y! N FEE CURREIJT Y/N <br /> Address 1� Z( (}� ({W � ,; ,�{/ Liranse# ` r � �p 7� <br /> OTHER COMPANY -� <br /> SIGNATURE REGISTERED Y/ N rcc CURRENT Y!N <br /> Address !icense# i <br /> 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 i 1 1 t 1 t t 1 t t 1 1 1 i I 1 ! � ) 1 / i i 1 1 1 1 1 I 1 t 1 1 1 1 1 i i 1 1 1 1 1 1 1 i 1 I i 1 t <br /> RESIDEIdT1AL Attach(2j Pic:Plars;(2j sets oi Buiidi^g Piars,(t j set of Energy Fortrs,R-0-N Pertnit for new�ccns;ruction, <br /> Minimum ten(1Q)working days�?=r submittal date Reqwred onsit=,Gcnstrudion Plans,Sform.veeter Plans�r.!Stlf F=rr_e�r.sta!!ed. <br /> Sanitary Faclitie;&1 dumpstar,3ite W��Pa�r�i fcr subdiv�sions/large arojects <br /> COMMERCIAL Attach(3)comple!e sets of Bui!ding P!ans;.!�s a Lfie Safety Page,(?;set e!Energy Fortns.R-0-W Pem:i!tor nev cor.s!ruc!;or. <br /> Mirnmum ten(?0)woh.ing days after submittal date. Required onsrte.Constructier.Plans.Stamwater Plans w/SiR Fence installed <br /> Sanrtary Facdrties 8 i dumpster Site L"Jork Parmit fcr alf new proJects.All comme�aal requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Enguieered Plans <br /> °"PFv^PERlY SURVEY req�irvd fcr all NEW construction <br /> .+ • � • • � , y i�iLid I.i.i <br /> Direc6ons. <br /> Fdl out applicabon complete!y <br /> Owner 8 Contractor sign back cf appi;ca:ion,no:arized <br /> If over 52500,e Notice nf Commentement is required. (A/C upgrades over 57540) <br /> " Agent(for the contrector;or Power M Atto.^.:ey{tor!he a.merl wou!d be scmee.^.e with;ro!a.^.zed!e!ter frem axner authorizing same <br /> OVER THE COUNTER PERMITTING (Fran!of Application Onlyj <br /> Rermfs�f shingies Sewers SP_.ry�CP I I(l9f?dQS A/C Fenres{PIOUSurveylFootage) <br /> Driveways-Not over Coun[er A on pubhc roadways needs ROW <br />