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813-7H0-0020 City of Zephyrhi Is Permit Application Fax-613-780-0021 <br /> Buildi g Department <br /> Date Received <br /> Phone Contac!f•r Permitting -- <br /> Oxvner's Name —^�^ r� ���,�L ��oQ"+`C.S ��— Ovuner Phone Mumber 1��3' �77���yU <br /> Ouvner's Address P�(� S c�' t-�,� �S L Ovener F'hone Number <br />' Fee Simple Titleholder Name � Ovvner Phone R9urnber � <br /> Fee Simple Titleholder Addres� • <br /> � <br /> ,�JOB ADDRESS �, � S 1 LOT# �� <br /> SUBDIVISION PARCE !D# - <br /> ^ y - (OBTAIPIED FROM PROPERTY TAX NOTICE) <br /> WORIC PROPOSED e NEW CONSTR e ADD/A 0 SIGN Q Q DEMOLISH <br /> INSTALL REPAI <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> 71fPE OF CONSTRUCTIOM ,Q- � BLOCK Q FRAM 0 STEEL Q <br /> DESCRIPTIOfd OF MIORK �k% /�0��J <br /> BUILDIMG SIZE SQ FOOTAGE 11EIGHT - <br /> �BUILDING $ VALUATIO OF TOTAL CONSTRUCTION <br /> 2�c� <br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> OMECHANICAL $ - VALUATIO OF MECHANICAL INSTALLATION <br /> � <br /> QGAS Q ROOFING Q SPECI�4LTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOO I ZONE AREA QYES NO <br /> BUILDER C MPANY {"� `�--- O C,i,�-l 1u(f�Q� <br /> SIGNATURE R GISTERED Y/ N FEE CURRE� Y/N <br /> Alddress License# <br /> ELECTRICIAN C MPANY <br /> SIGMATURE R GISTERED Y/ M FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER C MPANY ' <br /> SIGNATURE R GISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RIiECHANICAL OMPANY <br /> SIGNATURE R GISTERED Y/ N FEE CURRE� Y 1 N <br /> Address License# <br /> OTHER OMPAMY <br /> SIGftlATURE EGISTERED Y/ (V FEE CURRE� Y/N <br /> Address License# <br /> ItESIDEMTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)s t of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facllities 81 dumpster;Site Work Permit fo� subdivisions/large projects <br /> COII�IIMERCIAL Attach(3)complete sets of Buildfng Plans plus a Lif Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit f r all new projects.All commercial requirements must meet compliance <br /> SIGN PERIlAIT Attach(2)sets of Engineered Plans. <br /> ""•PROPERTY SURVEY required for all NEW construction. -- <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is required. (EUC u grades over�7500) <br /> •• Agent(for the contractor)or Power of Attomey(for the owner)wou d be someone with notarized lette�frotn`owne�'auttio�izing_'§ame";:°,''""`� <br /> _ ; <br /> OVER THE COUNTER PERMITTING (Front of AppUcation Only) . .� , ��•'��-�`'•' �� ' ` <br /> Reroofs if shingles Sewers Service Upgrades A/C Fen es(Plot/Survey/Footage) , . . , �-" '` = �';= •- �-���� ` <br /> � �:r°,..�_� ���;-,,...�,_...... .. ..r;'t,,S �,��.� <br /> Driveways-Not over Counter if on public roadways..needs ROW '` �"���' � � y <br />