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813 -780 -0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department 3501 5/ CZ. — 4/706 _)r3 , Date Received 6/30/09 I Phone Contact for Permitting 1407 8 7 - 5557 Wort/ Owner's Name I ADVENTIST HEALTH Owner Phone Number Owner's Address 17050 GALL BLVD Owner Phone Number 1 Fee Simple Titleholder Name Owner Phone Number 1 1 Fee Simple Titleholder Address JOB ADDRESS 6748 GALL BLVD LOT# 1 SUBDIVISION PARCEL ID# J2-26 -21- 0010 - 02500 -0020 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT n SIGN I MOVE n DEMOLISH X INSTALL REPAIR PROPOSED USE I] SFR 1 COMM I OTHER I I TYPE OF CONSTRUCTION I BLOCK I FRAME n STEEL I—I OTHER I I DESCRIPTION OF WORK INSTALL NEW WET FIRE SYSTEM PER TENANT REMODEL BUILDING SIZE SCI FOOTAGE HEIGHT n BUILDING S VALUATION OF TOTAL CONSTRUCTION $27 , 200 .00 I I ELECTRICAL $ AMP SERVICE I I PROGRESS ENERGY Il W.R.E.C. Fi PLUMBING S Ii MECHANICAL S VALUATION OF MECHANICAL INSTALLATION I I GAS I—I ROOFING I I SPECIALTY I] OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I—IYES I]NO BUILDER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT 1 Y/ N I Address I 1 License* l 1 ELECTRICIAN COMPANY SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT I Y/ N 1 Address I 1 License IS I 1 PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1 Address I l License* I 1 MECHANICAL COMPANY • SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT 1 Y/ N 1 • Address I I License # I 11 OTHER COMPANY WAYNE AUTOMATIC F - RE SPRINKT,E RS SIGNATURE REGISTERED Y / N FEE CURRENT Y / N II Address 1222 CAPTTOL CT. OCOEE FL 1 License* b2390300012008 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Sift Fence installed, Sanitary Facilities & 1 dumpster, Site Work Permit for subdivisions/large projects 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. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. ""PROPERTY SURVEY required for all NEW construction. Directions: Fill out application completely. Owner & Contractor sign back of application, notarized 1 - - - - If over 82500, a Notice of Commencement Is required. (A/C upgrades over 85000) f1 ',- Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner sulk; *web mg - , OVER THE COUNTER PERMITTING (Front of Application Only) ! tt �O e ' - Reroofs Sewers Service Upgrades A/C Fences (Plot/Survey/Footage) I vet !MIS010 MNIw>M>N0 Y i Driveways -Not over Counter if on public roadways..needs ROW - r ea IMO O I 'k . 1 r