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e�a-7aaoozo City of Zephyrhill Permit Application Fax a��-�eaoo2� <br /> Buiiding QepaRment <br /> ' � Date Received � _ � <br /> Phone Contact for Petmi#tin <br /> 'T'T�f'I- <br /> Owners Neme { Owner Phonm Number J'"� V <br /> Owne�s Address�.J�-J�../1 1-4 � ..�1 � dwner Phone Number �� <br /> �-. <br /> Fea Simple Titlshotder Name Owner Phone Number �— � <br /> Fee Simple 7itlehold9f Addf066 <br />� � �_���� <br /> JOB AdDRESS � LOT# <br /> SUBDlttISlOPt ����'��7{�__��� PARCEL 1 ^ 1 "'��}{x.}""C.l{� � <br /> t <br /> (OBTAINED FROM PROPERN TAX NOTICEj <br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT � SIGN Q � DEMOLISH <br /> INSTA�L REPAIR <br /> i PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCT10N Q BLOCK Q FRAME � STEEL Q <br /> I _..-, <br /> DESCRIPTION OF WORK C] ��Y�- <br /> BUIIDING SIZE �� SQ FOOTAGf HEtGH7 <br /> BUILDING $ <br /> VALUATION Q TOTAL CONS7RUCTION <br /> I <br /> �ELECTRICAI. �/^�� AMP SERVICE � pROGRESS ENERGY Q W.R.E.C. <br /> \...T' <br /> .... <br /> P�UMBING �� /���� <br /> �MECHAt+iiCAl $� rZ� VALUATIQN dF MECHANICALlNSTAl.l.ATlON 1 <br /> �.3� � t <br /> iQGAS Q ROOFING Q SPECIAL � OTHER <br /> FINISNED FI.00R EI.EVATIdNS r`� FLOOD ZO E AREA QYES NO <br /> L <br /> BUILDER COMP NY � <br /> SIGNATURE REOIST RED Y/ N FEE CURREA Y/N <br /> Address � License# � � <br /> ELEGTRICIAA! CpMF NY ���.��t t. I t 1 1 t.1 dl�t!I Ct.t I i <br /> StGRlATURE � REGtS RED Y J M1I FEE CURREA Y I N <br /> �v�— <br /> ` L'�a .t�,d'! <br /> Address � License# <br /> � PLWMBER CI�MP NY � � <br /> SIGNATURE REGIST RED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> MECtlANICAL - CQMP Y �tGr�t l��Jz. �4•(�,,,,,-rF// � <br /> SiGNATURE RBG�sT eo Y 1 N FEE CURRER Y/N <br /> Address l.icense# C�(,�� /�/(J� <br /> OTHER � GQMP NY � <br /> SIGNATURE rtEGIST eD Y/ N FEE CURREA Y/N <br /> � Address �'�( <br /> , License# I <br /> � 11111111111111111111111111111111111 1111111111111111111111111111111 <br /> RESIDENS1Al. Attacb(2)Plot Plans;(2)sets of Building Plans;{t}set of E ergy Forsns;R-O-W Permit for new consWCtion, <br /> Minimum te�(t0)working days after submittai date. RequEr d onsite,Cansfruction Ptans,Starmwater Pians wi S3It Fence lnstelied, <br /> Sanitary Faatities 8 1 dumpster,Site Work Permit for subdi 'sions/large projects <br /> ' COMMERCIAI. Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Pertnit for new wnsVUCtion. <br /> Minimum ten(10)woricing days after suGmittai date. Requir d onsiie,Consttuction Plans,Stormuater Plans wt Silt Fence instatled. <br /> Sanitary Facilities&i dumpster.Site Warfc Permit for ait n projects.Atl commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERIY SURVEY required for all NEW construction <br /> Dlrections: <br /> Fill out application completely. <br /> Owner&ConVactor sign back of applicaGon,notatized <br /> !i over$2500,a Notice of Commencement Is requ3red. {AtC upgrades over 57500} <br /> " Agent(far the conlraclor)or Power of Attomey(for the owner)vrould be so eone wilh notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Qnly) <br /> Reroofs if shingles Sewers Service Upgrades AJC Fences{Plo SurveylFoofage} <br /> Driveways-Not over Caunter iF on public roadways..needs ROW <br /> il <br /> � _ <br />