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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> � ' Building Department <br /> Date Received �— I,2'2 p � 2. Phone Contactfor Permittin � �� yys __ y8 /a� <br /> Owner's Name � . P� ��1�e Owner Phone Number � �l � ^��Z 6 <br /> Owner's Address � 1 � / ��-p Owner Phone Number <br /> Fee Simple Titleholder Name N � Owner Phone Number <br /> Fee Simple Titleholder Address � '�1 <br /> JOB ADDRESS J� 1 � � ��'�� �e ILOT# � <br /> SUBDIVISION � PARCEL ID# � ' � - - CJ�"O '"O �—" "` - <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT O SIGN Q Q DEMOLISH <br /> B INSTALL e REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK � C ' 'R1'� -� � � `1 ��e Q � �� �'� { �~� "� <br /> BUILDtNG SIZE SQ FOOTAGE�� HEIGHT <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ � 2� <br /> �MECHANICAL $ ���+� VALUATION OF MECHANICAL INSTALLATION <br /> �� � J <br /> 1 <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> . <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 COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COMPANY � � r"��2 iC A � QYri� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � Y �� T V� � � License# �C�d � L d � � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1111111111111111111111111111 <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 Plans w/Silt Fence installed, <br /> .._._..-- r--.�...__ o . a.......,.......c:�..�n�,..�o......:�F...c��L,rlivicinnc/lornc nrnicr}e <br />