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s�3aso-oo2o City of Zephyrhills Permit Application Fax-813-780-00���j � <br /> Building Department I�- <br /> � �r <br /> Date Received � �'�G� I p��Contact for Permitting %l! (�� � – ��y� <br /> Owner's Name �'$i FL v/Z / � Owner Phorte Number <br /> Owner's Address /S "' ,����Sc-�']' �!�. //1l�2.���� Owner Phone Number <br /> Fee Simple Titleholder Name �' f K /1 _O U/t 4 Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � � 1 (, LOT# �� <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT � SIGN � � DEMOLISH <br /> INSTALL B REPAIR <br /> PROPOSED USE � SFR � COMM � OTHER <br /> TYPE OF CONSTRUCTION � BLOCK � FRAME � STEEL � <br /> DESCRIPTION OF WORK �, � y� S yy� � <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � W.R.E.0 <br /> �PLUMBING $ �I�!r� _ <br /> �2 7 �l vV �J <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> OGAS � ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> BUILDER COMPANY <br /> SIGNATURE 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 � / �. ` '' ! <br /> / COMPANY �(0 7/(�(�.i 'SI /�- / SSG c� <br /> SIGNATURE ri-c �� k [� C REGISTERED Y N FEE CURRE� Y/N <br /> Address ���� (,Z� Q � 1/ ��G�- License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �— <br /> RESIDENTIAL Attach(21 Plot Plans:!2)sets of Buildino Plans:(11 set of Enerav Forms�R-O-W Permit for new construction. <br />