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e��-�ea-oa2o City of Zephyrhilts Permit Appt'scation Fa�o-sis-7eo.4ox1 <br /> � ' ' 6uiiding Department <br /> • hr�'SS� <br /> Date Receixed �c'1 �s t'7 ��1� <br /> "r_r_nT�_�_ PhoneContacYfarPermitttng ,�.�.3tst '-t't <br /> - -r"I"�ir' <br /> �wnars Name �o � r i � Owner Phone Number c7n��` as�- �J$` <br /> Chvner's Address � d Owner Phone Number � � <br /> Fae Simple Titlehaldet Name Ownar Pfione Number �` � <br /> Fee Slmple TltlehatderAddress <br /> JOB ADDRESS SJ� �^1e. �,.,)V n ��S- LQT# � 3�'� <br /> susfl�vas�aa Frnerald �; a� PaRC�L�flte �?y -ata-at �t�oao- �i��at7-0.3U t> <br /> (OBTAINED FROM PROPERTY TAX NOT�E) <br /> WORK PROPOSED � NEw coNSrR 8 ADalALT � S{GN �] �] DeMOIlSH <br /> INSTALC REPAIR <br /> PROPOSED USE � FR Q COMM � O7HER i e <br /> TYPE OP CON9TRUCTlON Q BLQCK Q FRAME � STEEL Q <br /> �HSCFttP710N OF WORK �f.. �QCG � i Y1$�i�� 13�C 3�7 � A,Y� {� <br /> 6tJilDING S�ZE C� X �� i SQ FOOTAGE �b t HEIGHT �� <br /> QBUILDING � � !+��� VAIUATiOtJ QFTOTAI CONST12UC7IOt�t <br /> QELEGTRICAL $ AMp SERVICE �� Q pROGRESS ENERGY � W.R.E.C. <br /> � �PLUMBING $ � �� <br /> iQMECHAiVtCAl. $ � VA�UATI4N OF MECNANIGA�tNSTALlATION ��� <br /> QGAS Q OOFING Q SPECIALTY � OTHER <br /> iFtN!$HED FZOOR ELEVATlONS ROOp ZONE AREA QYES NO <br /> BUILDER CIJMPANY N a.�-�� rnob��e ��11?1 r�°� �n� <br /> SIGNATURE !, REGISTEREO Y I N FEE CUftREA Y(N <br /> Address J�O�� �1 �M�'afd, ��l'� / License# 7��f1loJio��� <br /> PL CTRIC�fAN ` ' 1 .� 4�,/f� - 'COMPANY ��+"t �tlt1�3E�' �t�.°L�'iG ^�` <br /> � �IG�UR� t�� rv-���-�';!� � R��isT�rtEO Y i H F�cuRrten Y 1 N <br /> �AdarOS � ��� 3rd ......L 7 w�1 7�{ L1C@t4Se# E�+r�L1D�S"'/ c3 <br /> PLUMBER ��`///` � CQMPANY �GU vtL{ }Y1oI7i It l`�OM.. I fI G � <br /> SIGNATURE (� r��is�aeo Yflu F�cuRpEn Y!N <br /> Address 13oa $ f m � ' (=G.3+1 � LlCense# �)�I�I�O�Dc�C.� � <br /> MEGNAHICA� ��1��, COMPAtdY ��a��...- � T" <br /> SIGNATURE t REGI5TERED I IJ FEE CURFiE� Y J N <br /> Address Ucense# �"V��� � <br /> I J <br /> �' OTHEA N7 p� COMPANY � �( �- <br /> SIGNATURE � REGISTERED Y F N FEE CURRE� Y/N <br /> Address License# {_� � <br /> IIIIIIIIIIIt11111111111111111111111111111t111111illltllllllif111111 <br /> RESIDENTIAL Attach(2j P101 Flans;{2) ets of 6uik3ing Plans;j1�sat o€Energy Fprtns;R-0-W Permit Eor navr constr¢cticn, <br /> ARinimum ten(10}working deys aHer su6mirial date. Required onstte,Constrvction Ptans,Stomrwater Ptans wl Sit Fence iastatied, <br /> SaniYary Facflitles 81 tlu pster,Site Work Partnk for subdivisfonsllarge projects <br /> COMMERCIAL Attach(3)complete sete Buiiding Pians plus a Life Safety Page;('I)set of Energy Forms.R-O-W Pertnit for new constructian. <br /> M�nimum tep{90)working days aifer salamitta!date. Reqa4red onsite.Gonstrucfion Ptans,Starmwater Ftens wi Siit Fence insfailed, <br /> Sanitary Faeitittes 8 f du pster.Site Woric permit far att new projeets.AU commerciat raquirements must rneet compliance <br /> SIGN PERMI7 Attach(2)sets of Enginee ed Plans. <br /> •"'PROPERTY SURVEY required fqr all N�W eanstruciion. <br /> Directions: <br /> Ffll out applicadon complelely. <br /> Ovmer&Contractar sign back of appl'ica ion,notarized <br /> llover 52500,a Notice of Commence anf is required. {AtC upgradas aver 5750Q} <br /> " Agent(for the contractor)or Power of Att mey(for lha owner)wouid be someonB with notarized letter from owner authorizing same <br /> pYER SNE CQUNTER PERMITTING { ront of Applicetion QnSy} <br /> Reraafs tf shingtes Sewers Secvi Upgrades A!C Fences{PIoVSutveytFootage} <br /> Driveways•Not over Countet ii on pu6lic oadways..needs ROW <br />