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09-8976
Zephyrhills
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2009
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09-8976
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Last modified
1/12/2011 11:28:17 AM
Creation date
1/12/2011 11:28:15 AM
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Building Department
Company Name
ADVENTIST HEALTH SYSTEM
Building Department - Doc Type
Permit
Permit #
09-8976
Building Department - Name
ADVENTIST HEALTH SYSTEM
Address
38240 DAUGHTERY RD
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813 - 780•0020 • City of Zephyrhills Permit Application D � Fax - 813 - 780 -Q021 <br /> Building Department <br /> Date Received 3— *0 Phone Contact for Permitting 7027 5w f - -73 i <br /> . ttttt - .... <br /> Owner's Name ' / e71 .SjiSTCYjJ (� /3 7f 6// <br /> Owner Phone Number <br /> Owner's Address 7d,3 ? G,...3 _ / VQ Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 3(01/0 ,0j9 a6 -/yr7� ,2) LOT # C, <br /> SUBDIVISION I PARCEL ID# ed - d 4 '-0 6 /6 -(?OCO©" Q /O <br /> (OBTAINED F OM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD /ALT I SIGN MOVE I DEMOLISH <br /> X INSTALL REPAIR <br /> PROPOSED USE I I SFR I I COMM I OTHER I <br /> TYPE OF CONSTRUCTION IT BLOCK I I FRAME I I STEEL I I OTHER ( <br /> i <br /> DESCRIPTION OF WORK // l L 62 ,J/ 1 .97 11 U L'v4ZL S% G , 1/s 'j; // S y— , <br /> BUILDING SIZE SO FOOTAGE HEIGHT <br /> FffillaffifftWIN <br /> Ird BUILDING $ VALUATION OF TOTAL CONSTRUCTION /7 6C- z9 cc; <br /> I I ELECTRICAL $ AMP SERVICE I I PROGRESS ENERGY I I W.R.E.C. <br /> I I PLUMBING $ <br /> I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> 1 I GAS I I ROOFING I I SPECIALTY I I OTHER <br /> FINISHED FLOOR ELEVATIONS. FLOOD ZONE AREA I (YES I <br /> . . . . <br /> MIMI <br /> Iw <br /> BUILDER / COMPANY <br /> SIGNATURE REGISTERED Adi N FEE CURRENT r N I <br /> SW <br /> I <br /> Address U�,,�/ ��i5/�c sr J260 ic 227? 2 License # el-S O G X043 <br /> ELECTRICIAN COMPANY <br /> ,( <br /> SIGNATURE [ ' REGISTERED 1 Y / N I CURRENT Y / N <br /> I I I <br /> Address T License # <br /> COMPANY <br /> 1`/ y <br /> SIGNATURE REGISTERED 1 Y / N FE CURRENT Y / N <br /> I I I <br /> Address [ License # <br /> MECHANICAL /� / .� COMPANY <br /> SIGNATURE [ REGISTERED Y / N F CURRENT Y / N <br /> l I I I <br /> Address [ License # <br /> / <br /> OTHER /�/J' COMPANY • <br /> SIGNATURE L REGISTERED Y/ N FEE CURRENT Y / N <br /> I I I I <br /> Address <br /> License # <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 dumpster; Site Work Permit for subdivisions /large projects <br /> COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R -O -W Permit for new constructign. <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt 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 /> , t :au E: E4 uSl SI i llll::: l:;l::,,:::I, . .. .. <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized <br /> If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000) <br /> ** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNITER PERMITTING (Front of Application Only) <br /> Reroofs Sewers Service Upgrades NC Fences (Plot/Survey /Footage) <br /> Driveways -Not over Counter if on public roadways..needs ROW <br />
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