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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting — <br /> r� <br /> Owner's Name CL 1-l UAQ 7.a- hb ram Q- Owner Phone NumberOwner's Address 3 -1 c)5 9 Ave. Z Owner Phone Number <br /> Fee Simple Titleholder Name I I Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 38905 of th AV2, -2 e—joky r(Li I15, F&,, 3354 LOT# 12/ i3,l�l, lS <br /> SUBDIVISION PARCEL ID# 11—-2(.—2.1 d 0 1 0 ' 0 7 9 00 —' U 12. <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT = SIGN = = DEMOLISH <br /> e INSTALL B REPAIR <br /> PROPOSED USE = SFR = COMM = OTHER <br /> TYPE OF CONSTRUCTION = BLOCK = FRAME = STEEL = <br /> DESCRIPTION OF WORK at aU4x1.a/'1+ AE74'CHED 6/tIZ O L (FLi 0 o `f- <br /> BUILDING SIZE I I SO FOOTAGE HEIGHT <br /> BUILDING $ ' (O�1 Q VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ T AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY {'(� l Jv` �Q 6 <br /> SIGNATURE REGISTERED I Y/N FEE CURREN LY2 <br /> Address I License# C E (p <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/N FEE CURREN Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y/N FEE CURREN <br /> Address I License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN Y/N <br /> Address I License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I Y/N FEE CURREN Y/N <br /> Address License# <br /> ttit'itttititittititiitIItiti its vital ffiiiiiittiiti lag gifts iii-iili.i.iii <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1),set of Energy Forms;R-O-W Permit for new construction, <br />