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11-12168
Zephyrhills
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2011
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11-12168
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Last modified
5/10/2012 11:47:02 AM
Creation date
5/10/2012 11:47:00 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
11-12168
Building Department - Name
S C NURSING HOMES OF ZEPHYRHILLS
Address
38250 A AVE
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�' 813-'780-0020 City of Zephyrhills Permit Application Fax-813-78 <br /> Building Department � 3 ��l <br /> Date Received �•� Phone Contact for Permitting -- <br /> � <br /> (� U ' � <br /> �er's Name J� l� Owner Phone Number L <br /> Ouvner's Address C t. Jt� � 3 �Owner Phone Number � <br /> Fee Simple Titleholder Name J>r Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 1 '�35 `rZ LOT # �� <br /> SUBDIVISION (� PARCEL ID# �- J- � - � <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR � ADD/ALT Q SIGN Q MOVE CJ DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED VJSE Q SFR 0 COMM � OTHER G�4 <br /> TYPE OF CONSTRUCTION Q BLOCK � FRAME Q STEEL Q OTHER �— � <br /> DESCRIPTION OF WORK ��� �� � ''n'n �-�L <br /> BUILDING SIZE �� SQ FOOTAGE HEIGHT <br /> �� BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> � � <br /> � EL.ECTRICAL �$ �I AMP SERVICE � PROGRESS ENERGY � W.R.E.0 <br /> � � <br /> � PLUMBING �$ � <br /> � <br /> � MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> � GAS Q� ROOFING � SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES ONO <br /> BUILDER COMPANY 1� 1�� U� � U��_ � L1 �. <br /> SIGNATURE REGISTERED � / N FEE CURR T Y N � <br /> Address � �`1 � � ug �� �e �� �) 3 3 License # �. ( 3�,'jv� G.+ —J <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # � � <br /> PLUMBER COMPANY <br /> SIGNATUR'E REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # �— � <br /> MECHANICAL COMPANY <br /> �NATURE REGISTERED Y/ N FEE CURRENT Y! N <br /> Address License # � � <br /> OTHER COMPANY <br /> Siui�filTUR� ^cC�C'''ER�D Y; P! F�E CUP.R�NT Y/ N <br /> Address License # � � <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of �nergy Forms <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster <br /> COMMERCIAL Attach (3) sets of Building Plans; (7) set of Energy Forms. <br /> Minimum ten (10) working days after submittal date Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster <br /> All commercial requirements must meet compliance. <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> ***"PROPERTY SURVEY required for all NEW construction. <br /> ""'V <br /> rections: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized <br /> If over $2500, a Notice of Commencement is required. (A1C 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 A�plication Only) <br /> Reroofs Sewers Service Upgrades A/C Fences (PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways. needs ROW <br />
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