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11-11964
Zephyrhills
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2011
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11-11964
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Last modified
1/16/2013 11:27:34 AM
Creation date
1/16/2013 11:27:28 AM
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Building Department
Company Name
FLORIDA MEDICAL CLINIC
Building Department - Doc Type
Permit
Permit #
11-11964
Building Department - Name
FLORIDA MEDICAL CLINIC
Address
38135 MARKET SQUARE DR
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813-780-0020 City of Zephyrhi�ls Permit Application � ax-d1�eo-oo2� <br /> . Building Departrnent � <br /> Date Received Phone Contact for Permittin - " <br /> Owner's Name �-�Q-►�� F.A l C AZ L 1� l Owner Phone Number � L f� ✓ � � ��1 � <br /> Owner's Address � Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number ��,� <br /> Fee Simple Titleholder Address I <br /> JOB ADDRESS LOT# � �P C'C� <br /> SUBDIVISION � PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEw CONS7R 8 ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE � -� Sp FOOTAGE� HEIGHT <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> PLUMBING $ � <br /> � �/��� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLA ION�� ,, � Q � � <br /> � �� l � <br /> OGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA YES �O / <br /> � ,, f. <br /> .� <br /> BUILDER COMPANY a- � G! <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 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,Constructfon Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilities 8�1 dumpster;Site Work Permit for subdivisio�sllarge 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 constructlon. <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 construcUon. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of appflcation,notarized <br /> If over 52500,a Notice of Commencement is required. (A/C upgrades over s7500) <br />'" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />
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