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�, , a�aaso-0ozo City of Zephyrhilis Permit Application Fax-a�a-�saooz� <br /> • � - Building DepaAment <br /> Date Receivad Phone Contact(or Permittln <br /> -n-rrrrrr - <br /> Owners Name owner Phone dumber 8139435123 <br /> Owner's Address 4917 Rollins t Owner Phone Numbor <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simpie Titleholder Add�esa <br /> JOB ADDRESS LOT q � <br /> SUBDIVISION S OB PARCEL IDq <br /> loarur�o Frtow raorerm rac Norx� <br /> WORK PROPOSED B NEW CONSTR 8 ADDlALT Q SIGN Q Q DEMOLISH <br /> tNSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER � <br /> TYPE OF CONSTRUCTION Q BLOCK Q Fi7AME Q STEEL Q <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE SO FOOTAGE� HEtGHT � <br /> QBUILDING 3 VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL S AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.� <br /> QPLUMBING $ � \� <br /> �� <br />� QMECHANICAL S 7�OOZ.00 VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FlOpR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUIIDER COMPANY I <br /> SIGNATURE qEGISiEAED Y I N FEE CURREA Y 1 N <br />, Address License q <br /> ELECTRICIAN �"� � COMPANY � F <br />� SIONATURE � ' REGISTERED YI FEECUpRE� /N <br /> Addreas �...!� li � Licensa# 31JiiX I <br /> PLUMBER COMPANY I <br /> SlGNATURE REGISiERED Y!N FEECUPAEn Y/N <br /> Address License# � <br /> IMECHANICAL COMPANY U UE O S <br /> SIGNATIJRE REC�SiERED Y f FEE CURRE� Y/N <br /> Addreas 451519TH ST CT E BRADENTON u�,�a CMC041072 <br /> O?HER COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURREA Y/N <br /> III <br /> Addrees Licensa N <br /> 1111111111111111111111111111111111111111111111111111111111111111111 <br /> RESIDENiIAL Aftach(2)Plal Pians;(2)sets of Buflding Plens;(1)sel of Energy Forms;R-O-W Pertrtit fa new consWcUon. <br /> Minimum ten(10)working deys a(tar submittal date. Required onsite.ConsW clian Pians,Stortnwater Plens wl Silt Fa�sce inslalled, <br /> Sandery Facilities 8 1 dumpster,Sile Woik Pertnll(a wbdfvisfonsllarge projeGs <br /> COMMERCIAL Attech(2)complele sets of Building Plens plus a LHe Se(ety Page;(1)set of Energy Fmrns.R-0-W Pertnft(w new consWction. <br /> Minimum ten(10)v�orking deys afler submittel date. Raquired onsita,ConsWclion Ptaiu,Stormwetar Piens w/Silt Fenee installed, <br /> Sanitary FeciRtfes 81 dumpsler.Site Work Parmit(or all new prqac�s.All commercial requiremenis must meet eomptianee <br /> SIGN PERMIT Attach(2)sals o(Engineered Plans. <br /> ""PROPERTY SURVEY required lor all NEW cansWcdon. <br /> 'i1111111i� •i• <br /> Directions: <br /> Fiil oul appiication completdy. <br /> Oxmer 8 ConVactw sign back of applicslim.nolarized <br /> If over i2500,a Notice of Commencemant fs requlred. (AIC upgradea over 57500) <br /> " Ac,�;nt(fa Ihe cartrador)w Power of Altomey(fw Iha owner)would be someorta with nolarized letter hom owner aullwiiang same <br /> OVER THE COUNiER PERMITTING (copy M contract required) =�� <br /> Reroofs N sMngles Sehers Servica Upgrades NC Fencas(PIoVSurveyfFaole�e) � <br /> C <br /> Drlveways-NW over Counter ii on public roadways..needs ROW � <br />\ I <br />