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s�s City ofi Zephyrhills Nermit Application �? rax <br /> . Building Department ,� I�� f D <br /> Date Recelved phone Contact for Permlttin � y �77� — <br /> �. Owner's Name ✓�' 20 T D' 'T n✓ Owner Phone Number <br /> t�, Owner's Address 3 �.� � a. �/Q � Ll/� ° ��-- Owner Phone Number <br /> Fee Simple Titleholder Name �— Owner Phone Number <br /> Fee Simple Titleholder Address <br /> � JOB ADDRESS F� 3 .�z ` l� �W �� � �iG LOT # � <br /> �SUBDIVISION Q R( Fr�O�,,� �, PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR� ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> � DESCRIPTION OF WORK �/1l D d W � P� G�/Yf /1� S 1 Z e S� �L <br /> BUILDING S12E SQ FOOTAGE�� HEIGHT <br /> d( QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANfCAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> � BUILDER ,CZ ._.. ,j')��5�(�„ � COMPANY <br /> SIGNATURE �� ���� �l REGISTERED Y/ N FEE CURRE� Y! N <br /> Address ' License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ 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 Ucense # � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # �— <br /> RESIDENTIAL Attach (2) Plot Pians; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Pemiit for new construction,. <br /> Minimum ten (10) working days after submittal date. Requfred onsite, ConstrucUon Plans, Stormwater P�ans w/ Silt Fence installed, <br /> _ Sanitary FaciliUes & 1 dumpster; Site Wor1c Permit for subdlvisions/large projects <br />