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e+�-�e�o City of ephyrhiils PermitApplication Fax-0�3'�80-002� ' <br /> Buitding Deparlmerd <br /> Date Recelved — (j-- Phorte Cortfact tor Pertnittin � I D � <br /> Owners Neme 1V '� � L Owner Phone Number � <br /> Owners Addfess �''ta_� AZ... Wrner Phwre Number <br /> Fee Simplo Titleholder Name Q Owner Phone Number <br /> F¢e Simpla Titleholder Address — <br /> JOBADDRESS LOT� �� � <br /> SUBDMSION PARCEL IDft o2 'a' •a' • � �1J"�[M� '��.7� <br /> (OHfAQJm FR017 PROPER7YTA%NOTICE) <br /> WOFiK PROPOSED � NEW OONSiR 8 ADD/ALT Q S16N Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM � OTHER <br /> TYPE OF CONSiRUCitON Q BLOCK Q FRAME Q STE0. � <br /> �ESCRIPTION OF WORK <br /> BUILDIN[i SIZF ' � � S�FOOT � I R 1 HEItiMT � <br /> 1�BUILDING $ �Q V UATION OF TOTAL CONSTRUCTION �����l�V <br /> [✓�ELECTRICAL $' P SERVICE Q PROGRESS ENERGY Q W.R.EC. <br /> �LUMBING $ /� <br /> �ECHANICAL $ V UAT10N OF MECHANICAL INSTAI.LATION � <br /> 1��� <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER ri�J/(�l� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � <br /> r <br /> BUILDER COMPANY G <br /> SIGNATURE rt[-cisiea� Y N �cuarien N � <br /> Address ► l t `(,.� � License# .� �Z � e, � <br /> p � 5�1� � <br /> EI.ECTRICIAN (,�J ` COMPANY '` C� ✓ G� <br /> SIGNATURE // kECiSrEaED N , �CUwie. ' /N <br /> Addtesc r 1 Licerxe# ` �Z <br /> PLUMBER COMPANY W{ �� <br /> SIGNATURE R[-ctsTH�� Y N �cuwten N <br /> Address �e# (] <br /> MECHANICAL �ppypq�,�y , �� <br /> SIGNATURE R�sisteo N . �cuR�n N. <br /> � LiCense#f lJ�l�l�77�� � <br /> OiHER COMPANY <br /> ��T�� �sia�o Y! �ECUrtken Y/N <br /> aaa� u�e�# <br /> i � � �� � � � � � i � � � � � � �� � � � � � � �� � � � � i � � � � � � �� iii � � � �r � �� � �� � � r� � � �� � � o � <br /> RESIOENTIAL Affach(2)Plot Plans:(2)sets oF Buildmg PI ns;(1)set ot Energy Fortns R-O-W Pertnit for r�ew�ion, <br /> Minimum ten(10)�days after s�mit I date. Required ansite,CaisVuction Plars,Stwmwater Plans w!Siit Fence installed, <br /> - Sanitsry FaG'I�ies 81 dumpster,Site Work amit fw subd'rviswns/large projeps <br />� COMMERqAI. Attach(3)canplete sets d Buildmg Plans p s a Life SaFety Page;(1)s��Energy Fmrns.R-O-W P�mR for new oorsVudion. <br /> Min'rcnum ten(10)worldrg days aftgr su�n' al date. Required aisite,Canstnx:tion Plare,Stormwater Plans w/Sitt Fence instelled, <br /> Sendary Faa7ities 81 dumpster.�Site Work it for all rrew projeds.AO commerciai requaemeMs must meet compiiance <br /> SIGN PERh11T Attech(2)sefs of Eng'p�eered piarp, <br /> ""PROPER7Y 3URVEY recprired foraii om�stnution. <br /> D'uediorro: <br /> FII aA appCwation canpletely. . <br /> Owner B CoMractw sign beck af application,rrotar'vsd <br /> If over 52500,a NoHee of Commencement Is nqutrer. (A!C upg�adea over s76�) <br /> ° A9ent(ior Ure oorttrat�w)or Pawer of Arianey(for ttre )would be sameone with rrot�¢ed letterfrom owne�authwmng same <br /> OVER iHE COUNTER PERMITTING (FroM of Appl' ' pnty) <br /> ReroaFs if shirgles Sevuers Service Upgrades A!C Fences(PtoVSirvey/Faotage) <br /> Driveways-Not over Camta ii on p�iic roadways..needs W <br />