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8�3-�ao-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> � Building Department <br /> Date Received "� <br /> �� � Phone Contact tor Permittin ��✓� � �7-__`% L�� � <br /> Owner's Name j G� �" �� j y(� � / 11.5 Owner Phone Number <br /> 2 •�,�. <br /> Owner's Address �✓ % � � ��� Owner Phone Number <br /> Fee Simple Titleholder Name �— —� Owner Phone Number <br /> Fee Simple Titleholder Addresa <br /> JOB ADDRESS LOT#� � <br /> SUBDIVISION PARCEL IDN <br /> (OBTIVNED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT Q SIGN Q [� DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> � � <br /> DESCRIPTION OF WORK .�•�•'��j'�1/ �•17� L.i w�C /�,trc i l�,�✓f T � C,•7-�'�,S <br /> BUILDING SIZE �---� gp FOOTAGE� HEIGHT �C' � � <br /> OBUILDING S ��L��i �i� VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING Z <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY [� OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> ...�---� �,y <br /> BUILDER � � � ' ---� COMPANY L�5 /� .'t�'LG�- C�'�/�f'I'W� <br /> SIGNATURE � � . � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# "����/� l 7�- <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 License# � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Buflding Plans;(1)set of Energy Forms;R-O-W Pennit for new construction, <br />