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�»-,aU-,�V�U c�ty at Zephyrhill Permit Application Fax s�3asu-oo2� <br /> Building Department <br /> ' ` <br /> Date Received phone Contact fo Permltting � � <br /> Dwner's Mame �� S Owner Phone Number p��"r T�3" ��� <br /> Owner's Address Owner Phone Number '�� � <br /> Fee Stmpte Titteholder Name ' Uwner Phone Number �� � <br />� Fee SEmpte 7itfeholder Address <br />� 108 ADDRESS �i�c.#'" ' � I.L1T# �___�-_� <br />� SUBQIVl81C}N PARCEL 1 # <br />� - (09TAINED FROM PROPERTY 7AX NOTICE) <br /> 1MORK PEtOPOSEb e NEW CONSTR� ADDtAIT Q SIGN Q Q DEMOLISN <br /> INSTAtI REPAIR � <br /> PROPOSEp USE Q SFR, Q COMM CJ OTHER <br /> iYPE OF CONSTRUCTIQN Q ` BLOCK Q FRAME �� STEEL Q � <br />'� �ESCR��r�oK o�wo�t � " � � �' t t�-�� � �P� <br /> i . <br /> I BU!l.DINt�SlZE �� � SQ FC10TA�E HEIGHT C�� � <br /> [�BUILDING ��----�� VALUATION fl TOl'A!.CONSTF2UCTION <br /> LECTRICAL $ •��. � AMP SERYlC [�] PROGRESS ENERGY � W.R.E.C. <br /> QPLUMBING � $ (� <br /> � . f�t <br /> QMECHANICAL $ VALUATION O MECHANICAL INSTA�LATION <br /> � C <br /> QGAS [� ROOFING Q SPECIAL �] OTHER <br /> =1NISHED FLOOF2 ELEVATlONS r�� FL04D Z NE AREA QYES NO <br /> L <br /> 3UILQER P � _ CQM ANY C� ' �` �I v t Z fZ/���G L S , <br /> itC�NATt1RE (,Z�''iy�{,�4�-�° REGt RED Y/ N FEE CURRE� Y!N . <br /> Addres� C3cense# �i � <br /> _I.ECTRICIAM COM ANY <br /> a1GNATURE ttE��s a�o Y/ N ��cuRR�n Y/N <br /> Address �,{��gg# �� � <br /> 'LUMBER ' • ' -COM ANY <br /> 31CirNA7URE REGlB ERED Y! N FEE CURRE� Y/I�! <br /> Address � EJcense#.� � <br /> AECHANICAL COM ANY <br /> iiGNATU#tE a���s �R�Q Y! R4 ���cuRR�n Y 1 N <br /> Address l.Icense#,�� � <br /> )THER COAA ANY <br /> 4[GNATURE � RE��s �tt�o Y 1 N PEE CURREP Y 1 N <br /> Address l.icense# � - �� <br /> tESIDENTIAL Attach(2).Plot Plans;,(2)seks of Building Plans;(1)set of nergy Forms;R-O-W Permit for new construction, ; <br /> Minlmum ten{1Qj wotking days after submittaf date. Fisq red onsite,Constructton.Plans,Stormwa#er Pians w!Silt Fence installed, <br /> Sanitary FaclilNes 81 dumpster,Site Work Permtt for sub ivislonsAarge proJects � <br /> :OMMERCIA� Attach(3)complete sets of Buildfng.Plans pius,a Life Safe Page;(1),set of Energy Forms.R-O-W Permtt for new construction. _ <br /> Mtnimum ten{10}working days after sttbrr�itta!da#e. Reqa red onsite,Gonsbvc�on Plans,Stormwa#er Plans wl Si{t Fence instalied, <br /> Sanitary Fadlities&1 dumpster.Site Wortc Permit for ail n w proJects.Ali cammerclal requirements must meet compliance <br /> �IGN PERMIT Attach(2)sets of EngMeered Plans. <br /> ""PRCJPERIY SURVEY requlred for all NEW constructEo . <br /> ►Irectlon�: - <br /> Fi11 out appllcation completely. <br /> Owner&Conkractor sign back of appl(catlon,notarized _ <br /> If over�250q,a Notice of Commencement is requlred. (NC upgrad s over 57500) <br /> ' Agent(for the cantractor)�or Power of Attamey{for the owner)wouid be s meone with notarized letter from owner authorixing same <br /> IVER THE COUN7ER PERMITTING (Front of Applicadon Only) _ <br /> :eroofs If shtngles Sewecs Service Upgrades AlC Fences{PI USurveyiFootage) <br /> Driveways-Not over Caunler if on public roadways..neads RQW <br /> ' � <br />