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a�s-�an-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 0 <br /> � Building Department � <br /> Date Received Phone Contact for Permitting -' <br /> Owner Phone Number � � <br /> ier's Name --�'�"� <br /> Owner's Address v� Owner Phone Number I <br /> Fee Simple Titleholder Name !� Owner Phone Number <br /> Fee Simple Titleholder Address <br /> � . � LOT # 13 <br /> JOB ADDRESS '� " � <br /> SUBDIVISION m.�Y{ea �\Y5� �Ca� PARCEL ID# <br /> (OBTAINED FROM FROPERTY TAX NOTICE) <br /> �'�� MOVE DEMO�ISH <br /> WORK PROPOSED NEW CONSTR � A�lALT � SIGN Q C� <br /> e INSTALL REPAIR <br /> COMM Q OTHER G-Q <br /> PROPOSED USE Q SFR � -- <br /> TYPE OF CONSTRUCTION Q BLOCK � FRAME Q STEEL � OTHER �— <br /> DESCRIPTION OF WORK � �-' F 4 <br /> BUILDING S12E <br /> _� SGl FOOTAGE �O HEIGHT <br /> �� BUILDING $ � � VALUATION OF TOTAL CONSTRUCTION <br /> � ELECTRICAL $ <br /> AMP SERVICE Q PROGRESS ENERGY Q W.R.E.0 <br /> � PLUMBING $ <br /> � MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> � GAS Q� ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES QNO <br /> BUILDER COMPANY 1 � I11 �� ` � �+ <br /> �j REGISTERED / N FEECURR T� Y N � <br /> SIGNATURE <br /> Address ���) ug �� � G �! ' 3 License# �(,��.1C.. ±�L �v.�Z+ <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRENT Y/ N — <br /> License # � <br /> Address , <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N , FEE CURRENT Y( N <br /> License # <br /> Address <br /> MECHANICAL COMPANY <br /> iNATURE REGISTERED Y/ N FEE CURRENT Y I N <br /> License # � <br /> Address <br /> OTHER COMPANY <br /> ^����T�R�p Y; �! F�E CURP.�NT Y/ N <br /> Sivi�fATURE � <br /> License # <br /> Address <br /> ._. _. . .... _ _ ..,. __._ _a o..:w�.... ol�.,e� !11 co4 nf Fnarnv Fn�rt1S <br />