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013-780.0020 City of Zephyrhills Permit Application Fax-013-780-0021 <br /> Building Department <br /> Date Received 01/22/2019 Phone Contact for Permitting r <br /> I I I t t l t l 1 1 1 1 1 <br /> Owners Name South Pasco Health Care Properties,Inc. Owner Phone Number 407-975-3000 <br /> Owner's Address 485 N.Keller Rd.,Suite 250,Maitland,FL 3 751 Owner Phone Number <br /> Fee Simple Titleholder Name N/A --- I Owner Phone Number <br /> Fee Simple Titleholder Address n <br /> JOB ADDRESS a 5n U3 OT It <br /> SUBDIVISION N/A PARCEL ID# <br /> (DWAINE.III..PROPERTY T�rice) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT I t/1 SIGN � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE 0 SFR 0 COMM 0 OTHER <br /> TYPE OF CONSTRUCTION BLOCK 0 FRAME /�S�TEE�EL �. l i - <br /> DESCRIPTION OF WORK U� 1/v (O OU_TC100� SeC-Q\r�A Y <br /> BUILDING SIZE L SO FOOTAGE HEIGHT f <br /> =BUILDING 5 VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL S AMP SERVICE PROGRESS ENERGY W.R.E.C. <br /> =PLUMBING S <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING F7 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISIEREU Yt N FeeGURREN YIN <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRER Y!N <br /> Address License tt <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED YIN FEE CURREN Y/N <br /> Address License# <br /> MECHANICAL (� ,,(� v COMPANY iC Or545 e0\r -1 !1C• <br /> SIGNATURE Own '_ T_"/a RECIIS`TERED /± Y/ N ^^FEE CURR=_/nt� Y/N <br /> Address i1�� QLl _/% _I- J/ r1_-7a/tS�4e# li�C.��'.2 00 <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN LY I N <br /> Address �— - License# f <br /> Illtllllllllllllilllllllllllilllllllllillllllllllllllllllllllllllll <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 /> Sanitary Facilities&1 dumpsler,Site Work Permit for subdivwsionstlarge projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(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 wl Sill Fence installed,. <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.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 /> Owner&Contractor sign back of application,notarized <br /> If over S2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> '• Agent(for the contractor)or Power of Allomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (cony of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A+C Fences(PlotiSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />