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12-12802
Zephyrhills
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Building Department
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Permits
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2012
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12-12802
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Last modified
1/28/2013 1:38:56 PM
Creation date
1/28/2013 1:37:02 PM
Metadata
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Template:
Building Department
Company Name
FLORIDA MEDICAL CLINIC
Building Department - Doc Type
Permit
Permit #
12-12802
Building Department - Name
FLORIDA MEDICAL CLINIC
Address
38135 MARKET SQUARE DR
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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Departrnent <br /> Date Received � 8�3 l� _,��,3 <br /> '' Phone Contact for Permittin <br /> Owner's Name a 2 �� � CA � •✓,�C. Owner Phone Number <br /> Owner's Address J�� ,� r'�- �2. Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number � � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS J � �I�f ,C�� � 7� � R�� I f- LOT# C� <br /> SUBDIVISION PARCEL ID# d L'Z-�'" 2-� ' ��C7 �b " �'c3 O � d C7 C <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CON57R B ADD/ALT � SIGN Q [� DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER / ,' rn�a Q <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK .�� '�er a o /< N'� �i� � . � c� F ,r-� <br /> BUILDING SIZE � SQ FOOTAGE� HEIGHT <br /> OBUILDING $/��� �° VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ � � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ c��- f �(/ � <br /> a� :�` �-'� e.�w,jl,u''"`s <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � ��� <br /> _ ��,, �w <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER N��� � � � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO ��-�-�_ �9-C'' <br /> ��.---�..._ <br /> (� --�� <br /> BUILDER �,,� COMPANY r��OCQ �d aJ$�QU G� �� ti C. <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Z D !�- R d.° Ce' License# �l 7.S`�D y� <br /> ELECTRICIAN f O . � COMPANY � -� ��2 � � ✓ <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ��7�� 'Wytt. , � License# �/•�f/���i����f <br /> � <br /> PLUMBER �� C��-� tQ COMPANY `-� 'R\�j �1 I�l�CY Z S � IQ� �,{,l <br /> SIGNATURE REGISTERED / N FEE CURRE� N __-.-'' <br /> Address c�.�vx 303 � Z �t`S ��- 3353 � ucense# �� I�-��J�OG o <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 submittai date. Required onsite,ConsUuctlon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciliUes 8 1 dumpster;Site Work Permit for subdivisionsllarge 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 Pians w/Silt Fence installed, <br /> Sanitary Facilities 8 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 consVucUon. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is►equired. (A/C upgrades over 57500) <br /> *" Agent{f tl�c!l�b�Power t�FAltorney(for vmer)would be someone with notarized letter from ovmer authorizing same <br /> '�?� �. �z <br /> OVER THE C t�N�ER,P�NIT,IWG (F►ont of Appli tion Only) <br /> Reroofs if shi (es S�eHCefs„, Servlce 4lpgrades_ C Fences(PIoUSurvey/Footage)��•� �<��+w�-�•. <br /> �� , <br /> 'R '7U ti�� <br /> Drivew �NOk qver C��Qt��f.qn public ro�inrays�..n s ROW � "'' �� • :j = <br /> . +�p�+°r�r.w�.,.� � � � ` � �^•g�3rA��1F. y• - <br /> , i:5 ��y��rt�• <br /> �:�,...,,�y,���o' � � .,. <br />
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