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813 -7'80 -0020 City of Zephyrhills Permit Application* /011 Fax -813- 780 -0021 <br /> Building Department 1 21- 4 - q !1�(, p <br /> Date Received 5- 10-- (0 l 71 D <br /> Phone Contact for Permitting <br /> Owner's Name Florida Hospital Zephyhills Owner Phone Number 813- 783 -6106 <br /> Owner's Address 7050 Gall Boulevard Zephryhills 33542 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 7050 Gall Boulevard LOT # <br /> SUBDIVISION PARCEL ID# 02- 26 -21- 0010- 02500 -0020 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED >< NEW CONSTR ADD /ALT n SIGN n MOVE I I DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE 1 1 SFR 1 1 COMM n OTHER 1 <br /> TYPE OF CONSTRUCTION n BLOCK 1 1 FRAME n STEEL I I OTHER 1 (n /,� <br /> Ti r 8 � <br /> DESCRIPTION OF WORK New temporary 200 amp single phase power pole for construction trailers N c o <br /> 6V <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> 1 BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> l© ELECTRICAL $ AMP SERVICE ET PROGRESS ENERGY 1x I W.R.E.C. <br /> 1950.00 <br /> ET PLUMBING $ <br /> I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> I 1 GAS I I ROOFING 1 1 SPECIALTY n OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IYES nNO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT 1 Y/ N 1 <br /> Address License # <br /> ELECTRICIAN APG Electric. Inc. <br /> s � CO MPANY <br /> SIGNATURE f "/ / REGISTERED 1 Y/ N I FEE CURRENT I Y/ N 1 <br /> Address 4825 140th Ave N Ste K Clearwater FL 33762 -3822 License # EC0000486 <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT 1 Y/ N 1 <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT 1 Y/ N 1 <br /> Address License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT I Y/ N 1 <br /> ' <br /> Address License # <br /> . ._ - <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 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 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 /> 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 COUNTER 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 />