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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received J 1 y Phone Contact for Permitting V 3 / 7 — 3 0`ly <br /> Owner's Name n O C- 4 L ► 15 LL C Owner Phone Number <br /> Owner's Address 1 ' `I Aq\` VI Cl 51 T-a�O 9-4 I m =Owner Phone Number <br /> Fee Simple Titleholder Name N Owner Phone Number <br /> Fee Simple Titleholder Address / <br /> JOB ADDRESS '3961 u C f -, , pp,rvk Z h\ 1g 3 I LOT# <br /> SUBDIVISION ^ e,��OC PARCEL ID# 9Li- aLO- a - 00U0 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT = SIGN DEMOLISH <br /> INSTALL E REPAIR <br /> PROPOSED USE = SFR 0 COMM = OTHER <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME = STEEL <br /> DESCRIPTION OF WORK :1-N s4A I Me vJ 13e6QiLT5HE-D@ [ax10 WilkE ,21 <br /> BUILDING SIZE I I SQ FOOTAGE HEIGHT <br /> BUILDING $ 50 0 VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATIONf!� ` <br /> =GAS ROOFING 0 SPECIALTY = OTHER L \ <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER �o• COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CUR EN Y/N <br /> Address J 135� �, Z rh�115 ��L ` `�a License# C�c �a�a�9u <br /> ELECTRICIAN 4�� f c1 COMPANY <br /> SIGNATURE ice---� REGISTERED Y/ N FEE CURREN <br /> Address P•D. bO C 3-7 L Cc ?35XI License# Et 3 o 13`83 <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address I License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# <br /> 1111111111111111111111111111111111111111111111111111111111111111111 <br />