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a»-.a�,�� city ot Zeph rhilis Permit Applicatian Fax-s�a-fi�aoo2� <br /> B Ilding Deparhr►ent <br /> Data Recelved �•p'��• �� phone Gon at for Permittin <br /> sa_. v� _�., .���� <br /> Dwner's N�me;. � CD;;-O' 7. � � ' :� � '�C)vvrie��Phone'Numbe'r✓' :�'/.j� ' �/,�' a�Q� <br /> , ;`n-� ¢ `: ',`;.5'... �V �[' � '�:,r�.'�..;t;��: r.�� � ,r:�;:,i,�: `�. � <br /> Dwner's Addr`ess O Q' "' s%'��� Q/`� /7' � �,O�+irier Phane�Number«�°.�,�.._, . <br /> Fee Stmpie Titleholder Namev Y Aw�ter Phone Number '� � <br /> . , ; s <br /> Fee Stmpte Titleholder'Address - - - <br /> JOB ADDR�SS • �OT# �___r� <br /> 5UBDIVISION �d X �t��t_r�cfDS' 1 PA CEL 1�# � � 04 l � � " d ��} 1�� <br /> , (OBTAINED FROM PROPERTY 7AX NOTICE) <br /> IMORK PRQRQSEb e NEW CpNSTR 8 AD /ALT . L� SiG(V Q [� DEMO�RSN <br /> DC INSTALL RE AIR <br /> PROPOSED USE Q SFR Q CO M � OTHER <br /> TYPE OF CONSTRUCTION Q SLOCK Q F ME Q , StEEL Q <br /> DESCRtPTtON OF WORK 1�� � �S /F�J <br /> SUILDIHG SlZE �� SQ Ft?OTACaE !�lE1GHT �� <br /> QBUILDiNG �_-----� ' �/ALUAT ON OF TOTAk.C4�ISTRUCTIOR! <br /> QER.ECTRICAL �—� ANlP SE VICE � PROGRESS EIVERGY- � W.R.E.G. <br /> QPLUMBING �S�� . <br /> �MECHANICAL $ �r � VAI.UAT ON OF MECHANICAL INSTALLATION ' <br /> QGAS Q ROQFING [� SP CIALTY [� OTHER ' <br /> =1NSSHED FLOOR ELEVATtONS � � FL OD ZONE AREA QYES NQ <br /> 3UILQER __ GOl!lP/elMlr _ - - - - <br /> 9Zi"`aA1A3lIr`�IE- - - - - ` � REGISTERED Y J N FEE CURREh Y/N <br /> Acldress Cficense# �� � <br /> °_I.ECTRtC1AN � � COMPANY <br /> 31faNATU12E � REGISTERED Y J Fi FEE CURRE� Y/M <br /> Address _ l.Icense# �� � <br /> �LUMBER - � COMPANY - <br /> 3iGNATURE - ttEG�sTEr�so Y! N �E cu�x�n ` Y/N ' <br /> Address Llcense# �� � <br /> AECHAIdICAL /�-'��� ,,,,. COMPAlVY , /'%� `� O�''M - CZ,R�j <br /> 31GNATURE ZL%�2i�'C� �' �' REGISTERED Y N . FEE CURRER 1d <br /> � ' l.icense# �!'�� �,,.�r���'� <br /> Address o�c�. GrtJ� , Q <br /> )THER COMPANY I <br /> �IGAiATURE ��s7EREO � Y! N FEE GURREA Y 1 N <br /> Address License# � � <br /> tESIDENTiAL Attach(2)Plot Plans;(2)sets of Building Plans;(1) et of Energy Forms;R-O-W Permit for new construcHan, <br /> Minlmum ten{1Q}wodcing days after submlttal date. Ftequited onslte,Construct[or�Plans,8tormwater Pians wi Sitt Fence)nstalled, <br /> Sanitary Fadll�es&1 dumpster;Site Work Permit i r-subdivislonsAarge proJects . <br /> :OMMERCIAL Attach(3)complete sets of Building Plans plus.a Lif Safety Page;(1)set af Energy Forms.R-O-W Permit for new consUvction. <br /> Minlmum ten(10}woriclrtg days after submlttaf date. Requlred onsite,Canstructlan Plans,Stormwater Ptans wl S11t Fence installed, <br /> Sanitary Faciii8es&1 dumpster.S(te Work Permit f r all new projects.Ali commercial requirements must meet complfance <br /> �IGN PERMIT Attach(2)sets ot Engineered Plans. - ,- - <br /> :*"PRt?PER'tY SURitEY required for a11 NEV1t con ction. <br /> qrectlons: y <br /> F411 au#appllcaUan a�mpletely. <br /> dwner&Contractor sign back of apqlication,notarized ' <br /> IT over S290d,a Notice of Commencement is.required. {AIC u grades aver;7500) <br /> ' Agen#(for the conhactor}or Power of Aftomey(for the owner)wou be s'omeone wtth notaKzed letter from owner authorizing same <br /> IVER TWE COUN7ER PERMITTING {Front of AppUcaBon Only) <br /> ,eroafs if shEngles Sewers Servlce Upgrades NC Fen s{PtoUSurveytFootage} <br /> Driv,eways-Not over Counter if on public roaclways..neads ROW <br />