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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />DATE RECEIVED <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME <br /> <br />East Pasco Medical Center <br /> <br />7050 Gall Boulevard - Zephyrhills, Florida <br /> <br />PHONE (813) 788-0411 <br />33541 <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) See Attached! BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICF.1 <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />_ALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />Os I GN <br /> <br />o MOVE <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />KJ COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE X <br /> <br />SQUARE FOOTAGE <br /> <br />~?'ttJ 4t <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 />PERMITS REQUESTED <br /> <br />IJl BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />QJ ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />QJ PLUMBING <br />Kl MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />U GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />o NO <br /> <br /> <br /> <br />SIGNATURE <br /> <br />~ COMPANY Poole Constructi~o.. Inc. <br />,J la~ STATE CERT OR REGIST # rr- rO?7A7h <br />~ CITY PROCESSING # 249 <br /> <br />****************************************************************** <br /> <br />BUILDER <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />COMPANY ZlPr- F1A"'+-'t';"', "'(];l"'. <br />STATE CERT OR REGIST # EC 0000486 <br />CITY PROCESSING # 17 ~ <br />. <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY Harper Mechanical Corporation <br /> <br />STATE CERT OR REGIST # CF CO-33860 <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />**********~******************************************************* <br />COMPANY HNrper MechNnicN1 Cnr~nrN+-;nn <br />STATE CERT OR REGIST # CM C042548 <br />CITY PROCESSING # <br /> <br />MECHANICAL <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />***************************************************************** <br />