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'slsaso-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received a'/ �/� Phone Contact for Permittin I> � O Z – � <br /> Owner's Name �-- �.�/ICIV' '� l�U�'►'�b Owner Phone Number ��� �� <br /> Owner's Address �� vV S ►� I O�- Owner Phone Number <br /> Fee Simple Titleholder Name � Owne� Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �1� LOT # � <br /> SUBDIVISION (�Y' ( �Q� l�t S PARCEL ID# � J '�� �o – – d O'�OC700�)' � �O <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT � SIGN Q Q DEMOLISH <br /> B INSTALL e REPAIR �.Q,j�� <br /> PROPOSED USE � SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL � <br /> DESCRIPTION OF WORK C9� �- �'�'�(OU� <' � 1� C�'e S ��O �`� <br /> BUILDING SIZE SQ FOOTAGE �� HEIGHT <br /> [�]BUILDING ,$,,,,���� '3 VALUATION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP SERVICE 0 PROGRESS ENER Q W. E.C. <br /> �PLUMBING $ � �� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �� <br /> � � <br /> QGAS � ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address ` License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y J N FEE CURRE� Y/ N <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # <br /> OTHE COMPANY l� � '`� 'v <br /> SIGNATU REGISTERED / N FEE CURRE� Y/ N <br /> Address � � S f 1 License # � ��-�a� <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set ot Energy Forms; R-O-W Permit for new construction, <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> S9flIt9N F9CI�ItIPS � � 1111fIlnRtP�' SIfP Wnrk Parmif fnr c� �hrlivicinncll�rnu nmicrfc <br />