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Sl1 -780-0620 City of Zophyrhills;Permtt,Appllrotlon F47t-$13=780 U021 <br /> Building Ueparlirleni - . <br /> I Date Received - - - - <br /> Ptiane.Contebt,far Perrriiffin <br /> Owner's:Name :Owner Phone_Number. <br /> OiKner's Address - _ Own <br /> er.Phone Number r� 1 <br /> Fee SIMPIe.TitletioiderNaroe � I Owner Phone Number <br /> Fee Simpt t eTl leriot der Address <br /> - - . <br /> roe ADDRIiss. , G � : . 1,_L r�! : •,���� ,:GAS._ -- GOT.# <br /> SUplitvfsioN �. PARCEL`ID# - <br /> (OBTAINED FROM:PROPERTYTAXNOTICEj_ <br /> 1!WORk PROPOSED Nli_d0NSTR 8 ADR%ALT Q SIGN' C] Q DEMOLISH <br /> El INSTALL REPAIR' r <br /> PROFO$ED'USE Q SFR: 0 CQti1M C� UTHER ' <br /> TYPE OF'CONSTRUCTiQN Q_ BLOCK STEEL.[� r _ <br /> FRAME: .0 _ <br /> OESCRIPTi.ON OF WoRk ��� ���f1�•� /�2r�i��i . t'�iQ,��r- /Z G�i <br /> BUILDING-SIZE _ SQ FOOTAGE HEIGFlT' <br /> =BUILDING, $ VALUATiON:OF TOTAL CONSTRUC`I1pN <br /> QELECTRICAI. $ AMP SERVICE [� PROGREStENERGY [� W.R.E C. <br /> -MBING =5 ��o <br /> MECHANICCAL � VALUATION OF 3MECi•IANICAI:INSTALLATION <br /> =GAS [ ROOFING Q :SI?ECIALTY' [_—] OTHER <br /> FINISHED FLOOR ELEVATIO FLOOD ZONE AREA 0 YES NO i <br /> { IF L - - <br /> } BUILDER COMPANY <br /> 'SIGNATURE REGISTERED . YIN FEEGURREN Y/"N <br /> Address License# �� 1 <br /> EI:ECTRiCiAN COMPANY <br /> SIGNATURE REGISTERED Y/N -- FEE CURREN Y/Id-. <br /> Address- License#` <br /> i - <br /> PLOWER %�' �✓ COMPANY <br /> SIGNATURE REGISTERED' Y./.N - FEE cuRREN /.N' j <br /> Address JN Cleanse#. .ell G9 ,I� . <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/N.' FEE CURREN _Y/N <br /> Address - 4 ense#, <br /> OTHER...... COMPANY <br /> SIGNATURE A661STERED, Y/N FEE CURIiEN <br /> Address License#1 <br /> a :z.r. ,tt w*4- .ill a-li tt;��ta.a.�A a � <br /> RESIDENTIAL Attach-(2)Plot.Plans.'(2)Sets:of Oullding Plans;(1)set_af Energy-Fpfh*R�W Permit fbrnew:construcUod,. <br />