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$7�-?8a-oo2a City af Zephyrhil)s P�rmit Applieation Fax-813-780-0021 <br /> � . Building Department <br /> Date Received Phone Contact for Permitting — <br /> Owner's Name � � Owner Phane Number ��c��Q��� <br /> Owner's Address -�+ � • �� Owner Phone Number �� � <br /> Fee Simple Titieholder Name Owner Phane Number � � <br /> Fee Simple Titleholder Address <br /> J08 ADDRESS ==s LaT# [__.� <br /> SUBDIVISION � � PARCEL!D# "� � � — <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORFC PROPOSED �NEW CONSTR 8 ADDIA�T � SIGN Q Q DEMOLtSH <br /> INSTALL REPAIR <br /> PR4POSEQ USE � SFR Q COMM � OTHEf2 <br /> TYPE QF CONSTRUGTION �BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK �� <br /> BUiLDING SIZE �— � SQ FOOTA�E�_� NEIGHT � � <br /> Os���'d��G �� VAL13ATiON OF TOTAL CONSTf2UCTtON <br /> �ELECTRICAL $�'i—� AMF SERVICE � PROGRESS ENERGY � 1N.R.E.G. <br /> � <br /> OP�UMBING �� r, f ���� <br /> � / <br /> MECNANICA� $ VALUATION OF MECHANIGAL INSTA�LATiON � <br /> ���� �� � � <br /> OGAS Q ROOF]iVG Q SPEC�AI..n 0 QTHEF2 `��l <br /> FINISHED FLOOR ELEVATIQNS �—� FLOOD ZONE AF2EA DYES NO <br /> BUtLDER CQMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CUfZRE� Y/N <br /> Address License# �! � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> PLUMBER � � COMPANY <br /> SIGNA7URE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> MECNANtCAL ' Ci/�j��� COMPANY �� t1t l <br /> SIGNATURE REGISTEREp Y/ N FEE CURRE� Y/N <br /> Address License# �i � <br /> OTHER � CQMPANY <br /> SIGNATURE RECaI5TEREp Y/ N FEE CURRE� Y/N <br /> Address License# � � , <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIMIIM111111111 <br /> � <br /> e.rea�e.e-.vr.:� wu.._� in�n�_.rsr...___i+�.�M1_._ _r rti:.:ue_�rn____�a�__�_:r_'_�.r'__.r-�n i�r r+_�x<____...____a...'_c_.� � <br />