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813-7,90-0020 , %a� � City of Zephyrhills Permit Application ® Sy Fax-813-780-0021 <br /> r Building Department 1wir4f- 21-/f 7 <br /> Date Received Phone Contact for Permitting <br /> Owner's Name r Owner Phone Number I cal �30 <br /> Owner's Address Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS -- , a V Q CA, 2— ' _ L LOT# p <br /> SUBDIVISION �WqV i I Q PARCEL ID# <br /> t '19 (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT = SIGN = = DEMOLISH <br /> 11 INSTALL ® n <br /> PROPOSED USE SFR Q COMM T© OTHER <br /> TYPE OF CONSTRUCTION BLOCK 0 FRAME = STEEL <br /> DESCRIPTION OF WORK f) Sqon , <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> =BUILDING 1$ 619 as VALUATION OF TOTAL CONSTRUCTION <br /> c <br /> =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. <br /> PLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING Q SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER f= _�____ J - COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN Y/N <br /> Address License# <br /> OTHER PANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN Y/N t <br /> Address ws- us +�tkK , . njqa License# 1CCC f 1 ,1 Alt' <br /> RFSInPKITIAI �o��\Rlnf`P nn�9��c if Rni n PI.—/1\eef of 1--,P—.-R_(1"\A/P.—if fnr Heal rnncfmrfinn <br />