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�� .i , <br /> s�s��ao-oozo City of Zephyrhills Rermit Application Fax-813-780-0021 <br /> � Building Department <br /> � � <br /> Date Received % f�v <br /> �� Phone Contact for Permitting 1_'� <br /> � � � 1 � �I� � � 1 � i � <br /> Owner's Name � � Iv� t � �`�(/ Owner Phone Numb � �� � �� � �I <br /> Owner's Address {,� J � �(� (i7 C( �'("t�ner p�ne Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> � <br /> Fee Sfmple Titleholder Address <br /> JOB ADDRESS �g �✓ �O �V'� L �P�1 f�l�1 6 C��°� LOT# � li <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROi OSED e NEw CONSTR e ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED'USE � SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTI I N OF WORK � �C l Z S�C�1/ <br />, BUILDING�IZE SQ FOOTAGE� HEIGHT <br /> �B�I ILDING $ 2Q � VALUATION OF TOTAL CONSTRUCTION <br /> ' �� � <br /> �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.0 <br /> OPILUMBING $ <br /> � -� ���s� <br /> � ECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � <br /> � <br />� QiAS 0 ROOFING Q SPECIALTY 0 OTHER <br /> iFINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> ` M,C��� <br /> BUILDER ' COMPANY <br /> SIGNATUR REGISTERED Y/ N FEE CURRE� Y/N <br /> �� <br /> Addre'ss License# <br /> i <br /> ELECTRIC AN COMPANY <br /> SIGNATU �E REGISTERED Y/ N FEE CURRE� Y/N <br /> Add�ss Licen # <br /> se <br /> PLUMBER COMPANY <br /> SIGNATUf�E REGISTERED Y/ N FEE CURRE� Y/N <br /> Addr Iss License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> Illllilllllllllllllllllllllllliillllllllllllllllllllllllllllllllllll <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms, R-O-W Permit for new construction, <br /> i�� I Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, ' <br />