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<br />OWNER'S NAME <br /> <br />JOB ADDRESS <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />DATE RECEIVED <br />PLANS REVIEW FEE <br /> <br />East Pasco Medical Center, Inc. PHONE (813) 788-2411 <br />7050 Gall Boulevard, Zephyrhills, Florida 33541 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />See Attached <br /> <br />{OBTAIN FROM PROPERTY TAX NOTTCEl <br /> <br />PARCEL ID # <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />WORK PROPSED:ONEW CONSTRUCTION <br />OSIGN <br /> <br />[J ADDITION <br /> <br />o MOVE <br /> <br />:KJALTERATION <br />o DEMOLI SH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />KlCO:MMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWI:MMI~G POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />Geriatric Psychiatric Renovat~on <br /> <br />BUILDING SIZE <br /> <br />DESCRIPTION OF WORK <br /> <br />SQUARE FOOTAGE <br /> <br />RESIDENTIAL: <br />CO:MMERCIAL: <br /> <br />-m BUILDING <br />rn ELECTRICAL <br /> <br />rn PLUMBING <br />rn MECHANICAL <br /> <br />o GAS <br /> <br />6a ROOFING <br /> <br />HEIGHT <br /> <br />ATTACH (2) PLOT <br />ATTACH (3) SETS <br />PROPERTY SURVEY <br /> <br />PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY <br />OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />REQUIRED FOR ALL NEW CONSTRUCTIO~~ <br /> <br /> <br />PERMITS REQUESTED <br /> <br />FORMS. <br /> <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />[ I STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />o NO <br /> <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br />ELECTlUCIAN <br /> <br />SIGNATURE <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />OTHER <br /> <br />~~ ~ COMPANY Pool P. Con!'ltrnction Co . Tnc. <br />STATE CERT OR REGIST # C~ :C027876 <br />CITY PROCESSING # .~ f f f!}t- <br /> <br />****************************************************************** <br /> <br /> <br />COMPANY APG Electric, Inc. <br />~ CIl/~. ~ STATE CERT OR REGIST # <br />'- . CITY PROCESSING # <br />~~ . / <br />*******************tt**************************************~****** <br /> <br />.- <br /> <br />~~-~ <br /> <br />Har er Mechanic <br /> <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # ;;; g''3 <br /> <br />o <br /> <br />OKv- <br /> <br />****************************************************************** <br />~ . ~ COMPANY Har er Mechanical Cor oration <br />.. STATE CERT OR REGIST # Co <br />M~ ~ CITY PROCESSING # ~~X~'- OJ5---- <br /> <br />***************************************************************** <br /> <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />***************************************************************** <br />