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ai3aao-ooso City of Zephyrhilis Permit Application Fara»-�aaoozi <br /> Building D�Dartn+em <br /> Date Reeeived <br /> T T-� Phon�Canta�i Lor Parmilfl <br /> Qrmers Name � �� i � Umer Phone Number � ' � � <br /> Owner's Address � !`� r �r1.. r• Owner Phone Nunher <br /> Fee Simple Titlehdder Name Owner pf�one Numb�r <br /> Fee Simple Titlehdder Address <br /> JOB ADDRESS �'"� �J LOT� I I <br /> suao�visioN -Q � Or Pa���o�e 1�-�0- - ZU-- " ' 1 f� <br /> (OBTNAIE�FACY PROlB2TV TAY NOTIt� •• <br /> VVORK PROPOSED � NEW[ONSTR AOD/A�T Q SIGN Q Q pEMp��SH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION � BIOCK � FRAME � STEEL O <br /> OESCRIPTION OF WORK c�.. � <br /> BUILDING SRE SO FOOTAGE[�� HEIGHT <br /> �BUILDWG $ ^� <br /> r� y J � VALUATION OF TOTAL CONSTRUCTION <br /> w <br /> DELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY W.RE.C. �' <br /> �PLUMBING $ — �� <br /> I ' � <br /> QMECHANICAL a VALUATION OF MECHANICAL INSTALLATION � <br /> � <br /> OC"� Q ROOFING � gpECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> +_._•-_.�__._.. <br /> BUILDER CONPANY � <br /> SIGNATURE r�c,is�r�o Y/ N �cua�n V/N <br /> Mdress <br /> License At <br /> ELECTRICUW CONP/WY <br /> SIGNATURE <br /> r�c�a�o Y J N ��� Y/N <br /> Address License# —� <br /> PLUMBER C�P� � <br /> SIGNANRE <br /> �c�s��o Y/ N �E cuRt�n Y/N <br /> Addreu <br /> Lice�e# <br /> MECHANICAL COMPANY � <br /> SIGNATURE REGts7ERED V! N <br /> �cukaEn Y/N <br /> Addras <br /> License# <br /> OTHER C0111PANY � <br /> SIGNA7LRE � <br /> REGlSTERED (L�Jl N J FEE CURRE� /N <br /> /�dress � r l�'� License#�(,7����� <br /> IIIIIIIt1111 � 111 � 1111111t1111111111111111111111 � 1111111111111111111 <br /> RESIDENTIAL Attach(2)Plot Plans:(2)sets of BuiWing Plans�(1)set d Energy Forms�R-o-W Pelmit for new construdian, <br /> Mmimum ten(10)waking days aryer Sub�ttal�te. Requmed a�sRe,conswaion pa„s,S[ortnwater Wans w/Sit Fence installed, <br /> Sanifary Fac�li�es&1 dumpster,Si[e Work Pertnit far sub�visions/large proje� <br /> COMMERCIAL Atta�h(3)ra��te sets of Building Plans plus a Life Safety Page;(1)set of Ene�gy Forms.R-O-W P�ni[for new consWction. <br /> Minimum ten(10)w°'kin9 deYs aRer submittal date. Requied onsit� Cmstruction Flans.Stormwater Plans w/Si[Fence i�stalled, <br /> Sarotary Facilities&1 dumpster_Site Waic Permi�/er eq�er�,pr�j� qd�m������must meet compliance <br /> SIGN PERIII�T Attach(2)sds of Erxaneered plans_ <br /> ""PROPERTY SURVEY�eqwred for aB NEW construaUon_ <br /> Directiw�s: <br /> FiY out appli�tipi completeh,. <br /> Owner&Contractor sign pack a{�pp�.,ation,notarized <br /> If over 52500,a Notice of Cam�eM Is requlred. (1UC uP9rades over i7500) <br /> •• Agent(for the contractor)or Power ot Attomey(for M�e owner)would pe someone,,�h notyr����g fr����ang same <br /> OVER THE COUNTER PERMf17ryrG (FroM d A�plicatipi p�dy� <br /> .°.eroofs ff shingles Sewers gervic�Up�ades A/C Fences(PI�/Survey�Faot�ge� <br /> DNveways-Not over Countg ff on p�Wi���yyey� �s ROW <br />