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.a�s-�ao-oozo � City of Zephyrhiils Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received <br /> Phone Contact for Permitting <br /> 1 1 1 1 1 1 1 1 1 1 1 i 1 -- <br /> Owner's Name (`� �/�° S �" '(Q�� �.° l�/k Owner Phone Number <br /> Owner's Address (J .� r� s� Owner Phone Number � <br /> /1_ �/ <br /> Fee Simple Titleholder Name �r S (_CJ'�U Owner Phone Number <br /> Fee Simple Titleholder Address (..�� F��d% / S f� 1 3 �s ,� <br /> JOB ADDRESS G't /� �� �� r 3�7�p LOT # � <br /> SUBDIVISION PARCEL ID# �/ �' �CC' � a � ~ '�jc�} JG " �(�(i�' '�8,�' f <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT � SIGN � � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR � COMM � OTHER <br /> TYPE OF CONSTRUCTION � BLOCK � FRAME � STEEL � <br /> DESCRIPTION OF WORK C6nS'�/L / ��t ' ('�� (� � � � (,c� ���,,lj`�Qt'(� <br /> BUILDING SIZE SQ FOOTAGE l.��CD HEIGHT C/ � G j <br /> �BUILDING $ ,.�j � VALUATION OF TOTAL CONSTRUCTION <br /> (,/ c��. <br /> �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � W R.E.0 <br /> PLUMBING v�� <br /> o $ „� j �� 3�r sl�.� � <br /> ��' �'' �� <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �� �� � ' <br /> ra' s� G� [ �f'.,�'r'� <br /> QGAS � ROOFING � SPECIALTY � OTHER ` �Q�� �� <br /> z 3 � � <br /> FINISHED FLOOR ELE`✓ATIONS FLOOD ZONE AREA �YES NO� �� �� <br /> .'� ,�4? � ��°" $�� <br /> BUILDER CpMp`p�,��� ��l f� 4 � � <br /> SIGNATURE ` REGISTERE Y/ N E CURRE� Y/ N <br /> Address � License # ��C /��(/U��"' <br /> , <br /> ELECTRICIAN COMPANY � � L <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y! N <br /> Address , ,ry ,3 License # �G/,3(�(7 13 �3 � <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 � <br /> License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address � <br /> License # <br /> 11111111111111111111111111111111111 <br /> RESIDENTIAL Attach (2) Plot Plans, (2) sets of Building Plans, (1) set of Energy Forms, R-O-W Permit for new construction, <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Pians w! Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/larqe proiects <br />