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<br />APPLICATIOWl FOR PHRKIT <br />CITY OF ZEPJIYRIITLLS <br />BUII.DlliG DEPARnIE'JiJ'T <br /> <br />OWNER'S RAKE East Pasco Medical Center PHONE <br />OWNER'S ADDRESS 7050 Gall Boulevard, Zephyrhills, Florida 33540 <br /> <br />(813) 788-0411 <br /> <br />JOB ADDRESS <br /> <br />7050 Gall Boulevard, Zephyrhills, Florida 33540 <br /> <br />LEGAL DESCRIPTION: UJI'(S) <br /> <br />See attached BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D.' <br /> <br />RORK PROPOSED:_Nev Construction --2LAddition _Alteration _Rep."lir _Install <br /> <br />_Sign <br /> <br />_lIfove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />_KIF <br /> <br />_' o:f UTnits <br /> <br />_K/H <br /> <br />_ec:-ercial <br /> <br />_Indust. <br /> <br />_Swill. Pool <br /> <br />Other <br /> <br />_Restaurant &: Bea11:h Depart:.ent Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />; <br /> <br />RESIDENTIAL : <br />COHKERCIAL : <br /> <br />ATTACH (2) PUJI' PI..ARS &: (2) SEI'S OF BUILDING PLOJS &: (1) SEI'RNERGY FORKS.** <br />ATTACH (3) SEI'S OF BUD.DDiG PLUlS &: (1) SET EL'mRGY FORMS. ** <br />**COPV OF CONTRAct 1UlQ1JIIRED. <br /> <br />PEmtIlS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation o:f Tot:a1 Construction <br /> <br />_ELECTRICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_KECllAlUCAL <br /> <br />$ <br /> <br />Valuatiou of Mechanical. Installation <br /> <br />_PLUH.BING <br /> <br />GAS <br /> <br />KOOFDfG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTIOIiI: _Block _Fr;me _St~el <br /> <br />Other <br /> <br />FTIiISBED FLOOR ELEVATIONS: <br /> <br />PI' . <br /> <br />IS PROJEct IN FLOOD zmm AREA? <br /> <br />YES NO <br /> <br />***********************~****************** <br /> <br />corn'RACTOR SECTION <br /> <br />BUILDER <br /> <br /> <br />CO!IPMaY <br />State Cert:. or Regist:. 4# <br />City License Registration #/: CJ() <br />************************************** <br /> <br />Signature <br /> <br />ELECTRICIAN <br /> <br />CO!IPMY <br />State Cert:. or Regist:. 4F <br />City License Registration I <br />****************************************** <br /> <br />Si!!D.3ture <br /> <br />PLUKBER CO!IPMY <br />L / State Cert:. or Regist:. 4F <br />Signarore f/-~7' L. rJ-~ City License Registration , <br />~~ ~~t ~~~~~~~~..........~~~~~~~~.~~~.~...~~~.~.. <br /> <br />KEC'HABICAL amPMW <br />( State Cert:. or Regist:. , <br />Signature ~ I City License Registration I <br />Y '. Ii i 1 ******************"'*********************** <br />1j...rC. '-L)- --t.--LJ Ii- <br /> <br />OIBER COlfPMY <br />State Cert:. or Regist:. #/: <br />Signature City License Registration I <br />**********************~******************* <br /> <br />/tjT <br /> <br />/:J~ <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />