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� siaaao-oozo City of Zephyrhills Permit Application Fax-813-780-0021 I <br /> � Building Department i <br /> i : • <br /> �' <br /> i Date Received 08/10/2016 Phone Contact for Permitting 813 997 _ 6979 <br /> � � 1 1 1 1 1 1 � � � � � <br /> Iowners Name Health Care REITInc C/O Altus Group Owner Phone n►umber <br /> ,� <br /> i <br /> I owners address PO Box 92129 Southlake TX 76092 Owner Phone Number a <br /> i <br /> Fee Simple Titleholder Name Owner Phone Number i <br /> i <br /> I <br /> Fee Simple Titleholder Address -- <br /> JOBADDRESS 38135 Market Square Drive �or# � � <br /> SUBDIVISION PARCEL ID# 02-26-21-0010-03900-0030 <br /> (OBTAINED FROM PROPERTY TAII NOTICE) � <br /> WORK PROPOSED NEW CONSTR e ADD/ALT 0 SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OFCONSTRUCTION Q BLOCK Q FRAME Q STEEL Q ' <br /> i <br /> DESCRIPTION OF WORK Adding(4)devices(2)Hom Strobe and(2)SVobes to an existing Fire Alarm System ' <br /> i <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � � <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. I <br /> 2,490 <br /> QPLUMBING $ ` � ' ��� <br /> VALUATION OF MECHANICAL INSTALLATION � r J �I <br /> QMECHANICAL $ \� <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER � �/� ( ""'' i <br /> � � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO I <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N I <br /> Address License# ' <br /> ELECTRICIAN ��� COMPANY Fort Knox Fire&Communications Inc. I <br /> SIGNATURE an P C Ilins REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 4517 George Road Suite 240 License# EF20000876 <br /> � <br /> i � <br /> PLUMBER COMPANY i <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> � <br /> � Address License# <br /> MECHANICAL COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N � <br /> I <br /> i <br /> Address License# � <br /> i <br /> OTHER COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII11111111111111111111 I <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new construction, � <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 Pertnit for subdivisions/large projects � <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a L'rfe Safety Page;(1)set of Energy Fortns.R-O-W Pertnit for new construction.� � <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, ; <br /> Sanitary Facilities&1 dumpster Site Work Pertnit for all new projeds.All commercial requirements must meet compliance = <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. � <br /> ""PROPERTY SURVEY required for all NEW construction. � <br /> Directions:• <br /> , Fill out application completely , ' <br /> iOwner 8 Contractor sign back of application,notarized � <br /> I If over 52500,a Notice of Commencement is required. (A/C upgrades over 57500) <br /> i " Agent(for the contrador)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same ' <br /> OVER THE COUNTER PERMITfING (copy of contrad required) I <br /> j� Reroofs if shingles Sewers Senrice Upgrades A/C Fences(PlotlSurvey/Footage)� <br /> P <br /> IDriveways-Not over Counter if on public roadways..needs ROW <br />