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a��-�80-002o Ci�of Ze hyrhilis Pe�rnit Application F���aaao-ooa� <br /> , . Building Departrnent <br /> Date Received � � hack for Pemuittin — <br /> � Pho�e Co g <br /> Owner's Mame � ��"��� �.�E I���� �� ��� Owner Phone Plumb�r o I� ° t j ° �.��� � <br /> �ne�s�4dde�ess ��6 d�s! �� F���� 1'�� �evner Phone�lumb�� ������� P��Ca <br /> Fee Sernpl�gitleholele�Pfa�e ����'� ��.�'���`� �I Oeyner Phone Wumb�v <br /> Fee Simple Titleholeler Address ������ �°'`'��� ` ��� <br /> JOB a�o�SS �°' ��6 d�t� ���°�' �� �oT� �� <br /> sus�evisio►� � CEL ID# `Z�- 7i(— �� 3� �(�v(�(�-� C?(�O <br /> (OBTAIN�FRO►A PROPERTY TAX tdOTiC� <br /> WOR�t PROPOSED B MEW CONSfR 8 D/ALT � SIGPI � � DEAAOLISH <br /> IfVSTALL EPAIR <br /> PROPOSED USE � SFR Q OMM � OTHER <br /> ME OF COR1STfiUCT10N Q BLOCK Q R�4ME � STEEL � <br /> DESCRIPTIOfd OF HNORK �� �b��' ���� L.1�°� � d�+f� ���•� 1"i`t-� �6v„��. <br /> � �Rn a �f�!f 6'L�r.'°� I [.�� �i��/���!� <br /> BUILDIRIG SIZE ' '��,2 � �@�c�F' SQ FOOTAGE HEIGFiT � ������ � <br /> BUILDIiVG � ��,�9,,,� VAL TION OF TOTAL COfilSTRUCTIOtd <br /> At U � <br /> QELECTRICAL $ AMP ERVICE Q PROGRESS EfdERGY Q W.R_E_C. <br /> QPLUMBING $ ���� �� <br /> L.% � i <br /> QMECHANICAL $ VAL ATIOfd OF MECHANICAL INSTALLATION �� ��/ ' <br /> QGAS Q ROOFING Q PECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS � LOOD ZONE AREA QYES MO <br /> BUILDER CO{4!'!'lP�NY <br /> SIGtdR7URE REG�sfERm Y/ N FEE CuRREn Y/N <br /> p2ldress License# , <br /> ELEC'Ti21CIAl�1 COE�lIPAPLYY <br /> SIGtvATUR� �cisr�o Y/ M �cuw�n Y/N <br /> aaaress ucense# <br /> PLUAIlBER COMPAPIY <br /> SIGIefATURE REGISTERED Y/ N �cuw�n Y/Al <br /> Address License# � <br /> MECI�ANICAL COMPANY <br /> SIGtdA'FURE ��is�eo Y/ N �cu�n Y/M <br /> �ddr�s License# <br /> . <br /> OTHER G� �e� �6@� !G'���� !lAfPQNY ��1V�,�� <br /> SIGNATURE ���/ `�a/�P,'�yB�r�'�'�'., � � REGISTEFtED Y/ N FEE CuRREn Y/M .. <br /> . c � � a,E <br /> A�dr+ess ���C G�' ,�•rf t�,�j E�• .���� License# <br /> RESIDEI�fTiAL Attach(21 Piot Plans:(21 sets of Buildina Ptan :(1)set of Enarav Forms:R-O-1N Permit for new construction_ <br />