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s�s-�sa-oo2a City of Zephyrhills Permit Application Fax-813-78�-0021 <br /> Building Qepartment <br /> Date Received � �� phone CoMact tor Psrmltdn -Y�I� -- 7 7 Y D <br /> Ownar's Neme � Q� �/� 1" Ovmer Phone Number �D�-� - �� <br /> Owner's Address �o� � �`N �i��C 1 e- Owner Pho�e Number �— <br /> Fee Slmple Titlsholder Name Owner Phons Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 13 � jh� CC�L ''� LOT# [_��!�J <br /> SUBDIVI3IQN _ A e� �- PARCEL ID� ����'��^ ���-��O' t7��-D <br /> (08TAINED FROM PROPERTY TAX NOTICE} <br /> WORK PROPOSEO e NEW CONSTR 8 AOD/AlT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPdSED USE 0 SFR Q COMM � OTHER <br /> TYPE OF CON37RUCTION 0 BLOCK Q FRAME � STEEL Q <br /> DESCRIP7IQN OF WORK e C '�� �'1�I O I Q Q �0 D� � r/l P� (1/.�ll.� �'t�0 F S�S �` <br /> BUILOING SIZE I�x�3 �����o gt2 FOOTAGE O� HEIGHT 1 <br /> BUILDING $ Cf�4 �� VALUATION OF TOTAL CONSTRUCTION <br /> �v <br /> �ELECTRICAL � AMP SERVICE � PROGRESS ENERGY 0 W.R.E.C. <br /> �PLUMBING �� _ !e_-(�f'( ( " �� <br /> l'//� <br /> �MECHANICAL � VALUATION OF MECHANICAL ON <br /> �GAS � ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> BUILDER Q � �� + COMPANY 1 ���hJ'/1�2 d5 D(��+'/Ii r <br /> SIGNATURE U REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 3�/S S � - � a0�- / �1 I� License# C CC��j�j�`�� � <br /> ELECTRICIAN � � COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURREA Y/N <br /> Addross License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreaa L�cense# � <br /> MECHANICAL � COMPANY <br /> SIGNATURE Ktc�Sitktu Y/ N rtt cuHHtn Y t N <br /> Address T License# �— —� <br /> OTHER � COMPANY <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y I N <br /> Addross L+cense# <br /> RESIDENIIAL Attach(2)Plot Plans,(2)sets of Building Plans,(1)set of Energy Forms,R-O-W Permit for new construclion, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page,(1)set of Energy Forms R-O-W Permit for new construction. <br />