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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder NamJ <br /> <br /> <br />Fee Simple Titleholder Address I <br />JOB ADDRESS .3 &- 7 Y '1 <br /> <br />DESCRIPTION OF WORK <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />V- ~ v.{ <br /> <br />I <br />B <br />D <br />D <br />w <br /> <br />A.. 'V ~ LOT# I <br /> <br />PARCEL ID#I 0 L - L to - L \ - alto -()ODOO - 0 ipS 0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />t-...\ <br />1'-J 'U{ ~ <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />B <br />o <br />o <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />DEMOLIsH <br /> <br /> <br /> <br />OTHER <br />STEEL <br /> <br />I <br />I <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER I <br /> <br />BUILDING SIZE <br /> <br />SQ FOOTAGE I <br /> <br />..111................11..........11.111........11111..111.1111.11.......,1111......111111.........111.......11.1.....1..1.111111111111111111111111 <br /> <br />D BUILDING 1$ ,-/00 D. 00 I <br />D ELECTRICAL 1$ I <br />D PLUMBING 1$ I <br />D MECHANICAL ~ ROOFING I <br />D GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />1111111111..'....1111.11...11...11.1111111....11..........111.......................11....11..111111.............1111..1111.1.1111111111111...1111 <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br />I <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />pedweJs JO peJuIJd 'ped^J AJIllON !O 9weN <br /> <br />pedWBlS JO peJuIJd 'pedAJ AlBION !O aweN <br /> <br />.ON uOIsSlwwoO <br /> <br />.ON UOISSlwwOO <br /> <br />O!lqnd AJe~ON <br /> <br />O!lqnd AJeJoN <br /> <br />.uoneoYAuapI se <br />paonpo.ld aAelJjse4 JO aw OJ UMOUlj AlleuoSJad aJe/s! 01lM <br />Aq <br />S!1I aw aJOlaq (paWJ!Ile JO) 0\ WOMS pue paqlJosqnS <br />J.N3DV 110 1I3NMO <br />(EO"H ~ .S"::I> J.~nr Van::lOl:;j <br />"l.N311\13:>N311\111\10:> ::10 3:>1l.0N ~mOA DNICHO:>3H 3HO::l3B A3NHOll Y NY HO H3CN31 HnOA Hl.lM <br /> <br />.UoneoYlluepl se <br />peonpoJd 9AelJjse4 JO 9W OJ UMOU)! AueUOSJ9d aJe/SI 04M <br />Aq <br />SitU aw aJOlaq (paWJ!Ile JO) 0\ WOMS pue paqlJOsqns <br />1IOJ.OWJ.NOO <br /> <br />~- -- ---- ---- ...----. __ _...._...._._... ......'".".J~"..... ~.....Jw.....J <br />