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a�saao-oozo City of Zephyrhills Permit Application Fax-813-780.0021 <br /> Building Department <br /> Date Received' • <br /> Phone Contact for Rermitting ��� - ��1, <br /> Owner's Name � Owner Phone Number <br /> Owner's Address Owner Phone Number <br /> Fee Simple Titieholder Name Owner Phone Number <br /> Fee Simple Titleholder Addre�ss <br /> JOB ADDRESS �OZ.�l1vP_rG�CC�.. 'v . �h-�1s ��i�c�!/ LOT# � <br /> r <br /> SUBDIVISION 1 ve� PARCEL ID# C?- - ('j� � <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT � SIGN � � DEMOLISH <br /> 4NSTALL REPAIR <br /> PROPOSED USE 0 SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK ,1 � �~ <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT -• -- •- •--... ' . <br /> �BUILDING $ , VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> �'�LUMBING $ ' �'� <br /> �MECHANICAL , $ VALUATION OF MECHANICAL INSTALLATION �I f � <br /> � <br /> �GAS 0 ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> ._�� <br /> BUILDER� COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> '-� --r'-'t"'. .. .- <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N -• -- - �-- . <br /> Address License# <br /> PLUMBER . �`�� �y,._ (���� COMPANY � n <br /> SIGNATURE �`w�� � —� j' REGISTERED / N FEECURRE� Y!N <br /> �3S�o <br /> Address C��•� t'�CaC�9� 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 /> IIIIIIItllllllllllllllllllllllltlllllllllllllllllllllllllllllllllll <br />