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a�saaa-oo2o City of Z�phy hills Permit Application Fax-$13•780-0021 <br /> Bui ding Departmen# <br /> ,� , . <br /> Date Received Phone Contac for Permitting 2. Z- – ��� <br /> Owner's Name �� t-- �' �� Owner Phone Namber (�2�1 �z3`�d�g , <br /> Owner's Address g.��� �i r1�7"Ll�l��°-�` �/�`-� �� ��u Owner Ph n Ntimber ���.�3 ".�sd� � <br /> Fee Simple 7ltleholder Name L�°�7 �u�o� � Owner Phone Number � � <br /> FeeSimpleTltleholderAddress 3�S�1 �'"��7� d+�/ ���� � � °'/���1�-s' � -33-��� <br /> JOB ADDRESS g��/ �i'�?d Lo4v�'r ���.` G-e` � r�i� � �� 2 L07# �_�%'� <br /> SUBD►ViStON �—! � PAR EL ID# /r _J- - <br /> -- --- -- - �"""- - – -- (OSTAiNED PRQ144 PROPERTY TAX HOTICE) <br /> WORK PROPOSED e NEW CONSTR� AdD!¢�T � SIGN [� Q DEMOLlSH <br /> INSTAI.L REPdIR <br /> PRbPOSED USE Q SFR Q COM� ; � OTHER <br /> TYPE OF CON3TRUCTION Q BLOCK � FRA E � STEEL Q <br /> DESCR1PTtON OF WORK �? L�cr c .�i �o -U'in c�/d w� u.�i 7.fi ��e/'rnp �/1 e ��nd 0 ,s� <br /> BUiLDlN�SIZE �;�_��0� SQ FOOTAGE � � HEIGHT [�� <br /> QBUILpING $ � / ���`po VALUATt N OF TOTAL C�NSTRUCTtON <br /> l <br /> QEl.ECTR{CA� � � AfUlP SE ICE � 0 PRQGREBS ENERGY Q W.R.E.C. <br /> QPLUMBING ($`_..,_. � I�,fr�(A <br /> � r � y� <br /> �v. <br /> QMECHANICAI. $ VALUATI N OF MECHANICAL INSTALLA7lON G�� <br /> QGAS Q ROOFING � SPE IALTY � OTHER <br /> FINISHED FLOOR ELEVAI'IONS (�W/� FLO� D ZONE AREA QYES NQ <br /> L � <br /> -,� ,v <br /> BUII.QER j ,`�' OMPAt+lY <br /> SIGNATURE ''� �G��(il�"�`�`` �EGlSTEREQ Y! N �EE CURREI� Y/N <br /> Address .����� iJ�-' . I License# �T � � <br /> ELECTRICtAN � � ONlPANY <br /> SIGNATURE EGISTERED Y! N �EE CURREi� Y 1 N <br /> Addrass License# � � <br /> PLUMBER QMPANY <br /> SIGNATURE EGISTERED Y/ N EEE Ct1RREf Y/N <br /> Address License# �` � ' � <br /> MECHANICAL OMPANY <br /> SIGNATURE EGISTERED Y! N FEE CURREl� Y!N <br /> Address License# �— ^ � <br /> DTHER QI4RPANY <br /> SIGNATURE EGIST6REd Y/ N FEE CURREA Y!N <br /> ,_,,.___._._,,.._,,.._,,.., <br /> Address License# �i � � <br /> 2ESIDENTIAL Attach{2)Plot Plans;(2)sets of Building Plans;(1) et of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)wo�icing days after submittal date. Requfred onsite.Construction Plans,Stormwater Plans w/3(It Fence installed, <br /> SanEtary Facitities 8�1 dumpster,Site Work Permit f r subdivisionsJiarge projects <br /> ;,OMMERCIAL Attaoh(3)complete sets of 8uilding Plans pius a Lif Safety Page;{'f}set of Energy Forms.R-O-W Pemtit for new consfruction. <br /> Minimum ten(10)working days'after submittal date. Required onslte,ConstrucHon Plans,Stormwater Plans w!Silt Fence insta!led, <br /> Sanitary FacBifies&1 dumpster.Site Work Permit f r a(I new projects.All commercial�equirements must meet compliance <br /> 51GN PERMlT Attaah(2)sets of Engineered Plans. � <br /> `""PROPERTY SURVEY required far all NEW con trucuon. <br /> 71rea#ions: <br /> Fill out applicatian aompletely. _ - � <br /> Uwner&Contractor sign back of appiication,notarfzed <br /> If aver�25d4,a Notice a#Cammencement is required. (AJC u grades over$7500) <br /> ' Agent(for the conftactar}or Power af Attamey{for the awnerj wou d be sameane with notarized letter from owner authorizing same -. ,< .� � " <br /> 7VER TNE COUNTER PERMI�'TfFIG (Front of Apptication.Oniy} � , `, <br /> 2eroofs if shingles Sewers Service Upgrades,E1lC �" Fen s{PiotlSurveylFootage} � ',� � <br /> Driveways-Not ovar Counter if on publtc roadways..nesds ROW � � ; , ,_ .., ... , -._.. - `� <br /> i � _. ,< <br />