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96-6064
Zephyrhills
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1996
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96-6064
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Last modified
3/4/2009 2:49:57 PM
Creation date
7/19/2006 9:40:06 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
96-6064
Building Department - Name
LAKE MED CLINIC
Address
4941 4TH ST
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<br />(j) <br /> <br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />l) r :J C-<.-lf- K"\.<;"se I ) PHONE '7 B l~r:J7 80 <br />OIlIIER'S ADIlRESS '-( j L\ I L-I 11-- S+ Z. f 1t"'1 ~ I II oS ' <br />M~lclq rY\-w~ C lLMl C <br /> <br />OWNER' S NAKE <br /> <br />JOB ADDRESS <br /> <br />2:> c;. IAr-e.- - <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D. f /4 - ol,lP ~ a I ~ VOIO... f) I .:>.00 - 00 I 0 <br /> <br />(OBTAIN FROH PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition --Alteration _Repair _Install <br /> <br /> _Sign --'love _Deaolish <br />PROPOSED USE: _Single Faaily _H/F _, of Units _H/H <br /> _eo..ercial _Indust. _Swia. Pool _Other <br /> _Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: JZr2-pfA tJ of roo-F <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AtIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECllAlUCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PL~ING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FlBISHED FLOOR ELEVATIONS: <br /> <br />F1" . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />..............................*****.****** <br /> <br />CONTRACTOR SECTION <br /> <br />BIITIllER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />******..*.**************...**..*********** <br /> <br />Signature <br /> <br />F.l.RCTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration f <br />.......*************.*****.*..*.****.***.* <br /> <br />SionAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration t <br />**..******.**.****..**.*.***..************ <br /> <br />Signature <br /> <br />~ <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration . <br />..**..*...***************.*..*..********.* <br /> <br />Signature <br /> <br />OTRRR <br /> <br /> <br />COlfPMfY ~~I ~~ r-z~~k <br />State Cert. or Regist.' LLOO . <br />City License Registration' ;;rild-. <br />.*.***.***.******.*******..************* <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />
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