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a��-7aaoozo City of Zephyrhills Permit Application Fax-813-780-0021 <br />' Building Department <br /> Date�ceived Phone Contact for Pertnittin ��� — c�`Z�Z <br /> Owners Name � � �� Owner Phone Number <br /> Ownets Address � l0�` � Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple TiUeholder Address <br /> JOB ADDRESS �`� �� �' '•� '�� �� LOT# � <br /> SUBdIVISION � �1, PARCEL ID� C �� �'(j <br /> ' (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT Q SIGN Q Q DEMOLISH <br /> - INSTALL REPAIR <br /> PROPOSED USE Q SFR � COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIP710N OF WORK �N-C1'��`v� � V��.P�ov�(�fr�.�. <br /> BUILDING SIZE - � � SQ FOOTAGE� HEIGHT <br /> r' <br /> QBUILDING $ �� VALUATION OF 70TAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> OGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERm Y/ N FEE CURREn Y/N <br /> Address � v V�'7� � License# �� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTEREn Y/ N FEE CURREn Y/N <br /> Addr�s License# <br /> PLUMBER COMPANY ' <br /> SIGNATURE REGI5TERED Y/ N FEE CURREn Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISiERED Y/ N FEE CURREn Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREn Y/N <br /> Addr�s License# <br /> Illllllllllllllllllllllttllllllllllllllllllllllllllllllllllllllllll <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permft for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Canstruction Plans,Stortnwater Plans w/Silt Fence installed, <br />