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stia-�aaoo2o City of Zephyt�hill� Permit Apptication Fax-843-780-0021 <br /> , Building,Departrnent <br /> Date Received � �..( <br /> Phone Contact fo�'Permittin ' ( <br /> � <br /> Owners Name � Owner Phone Number - <br /> Owner's Address �� . � Qwner Phone Number <br /> � � <br /> Fee Stmple Titiehalder Name �! ; Owner Phone Number �- � <br /> � <br /> f <br /> Fee 9iimple 7ltlehalder Address � <br /> JOB AdDRESS � t Y� LQT# �___��� <br /> � <br /> SUBDMSIOM � � PARCE�1�D# � �,,� j,�� <br /> , (OBTAINED FROM PROPERTY TAX NpTICE) <br /> WORK PRCIPOSED r�ew Cot�srR ADDCALT' � SIGN [� Q DEMO�iSH <br /> INSTALL 8 REPAIR ' <br /> PROPOSED USE [� SFR Q COMM t � Oi'NER <br /> TYPE OF CONSTRUCTION [� BLOCK Q FRAME � � STEEL Q <br /> DESCRIFTION OF WORK !i ���' <br /> BW�DING SIZf ���� $Q FpQTAG£ � F#EIGHT ��� <br /> QBU1lDING 8 � VA�UATIOtV 0�TOTAL GONSTRUCTIC3N <br /> QEt.£CTRICAL � � AMP SERVIC$ Q PROGFtESS ENERGY Q W.R.E.C. <br /> � �� � <br /> QP�t1MBING �$� , �� <br /> i � <br /> �MECHANMCAL ��� � p� VA�UATION QF MECHAN(CAL INSTALlATlON <br /> �.--- , <br /> �GAS Q l20G1=1NG Q SPECIALTY �] OTHER , (� � � <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES NO �j <br /> BUII.DER CQMPANY <br /> SIGNATURE REGI�TERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> ELECTRICIAN GOM�ANY <br /> SIGNATURE ,,,__ ,,._,,.,,,. RE�tslrE�t�o Y/ N FEE CURRE� Y/N <br /> � <br /> Address r License# �- � <br /> P�UMBER CC}M�ANY <br /> SIGNATUFtE REGIS�TEREO Y/ N FEE CURRE� Y/N <br /> Address �icense# �� �� <br /> ,,.,.,.�;;�� � <br /> MECHANICAL COM�ANY <br /> SIGNATURE R�EGI5ITERED Y/ N FEE CURRE� Y/N <br /> Address License# ��: � 1 i���i.� <br /> OTHER Ct}N�ANY <br /> SIGNATURE REGI�TEREb Y/ N FEE CURRE� Y/N <br /> Address � �icense# � � <br /> RESIDENTiAL Attat�(2}Ptot Pians;{2}sets of Buikting Ptans;(1}set ofl Energy�amts;R-O-W Fermit for ne�rv�nstruct�on, <br /> Minimum ten(10)woricing days after submittai date. Re ired onsite,Construction Pians,Stormwater Ptans w/Siit Fence instailed, <br /> Sanitary Fadlitles 8 1 dumpster;Site Work Permit for su divisionsAarge projects <br /> CCtMMERC1At Attach(3}camplete sets of Suild#ng Plans plus a Life Saf�ty Page;{1)set of Energy Forms.R-O-W Permi#far new conshucHan. <br /> Minimum ten(10)working days after submittal date. Ftequired onsite,Constructton Plans,Stormwaiker Plans w!Sift Fence instailed, <br /> Sanitary Facilities 8 1 dumpster.Site Work Permit for all hew proJects.All commercial requirements must meet compliance <br /> SlGM PERMIT Attach{2}sets of Engineered Pians. � <br /> """'PROPERTY SURVEY required for all NEW constructibn. <br /> Direc#fons: ; <br /> Fill out application completely. , <br /> Ovmer&Conttactor sign back of applicaUon,notarized ' <br /> if over x2500,a Notfae of Gommenaement is requlred. {AtC upgra�es over=7500} <br /> •" Agent(for the contractor)or Power of Attomey(for the owner)would belsomeone wfth notarized letter from owner authorizing same <br /> OVER THE COUNTER PHRMt7TlNG {Front of Application Only} <br /> Reroafs if shingles Sewers Service Upgrades A/C Fences(i�loUSurvey/Footage) <br /> Driveways-Not over Counter ff on public roadways..needs ROW , <br /> � <br /> � <br />