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18-20002
Zephyrhills
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Building Department
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Permits
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2018
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18-20002
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Last modified
9/18/2019 9:43:14 AM
Creation date
9/18/2019 9:43:13 AM
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Building Department
Company Name
ADVENTIST HEALTH SYSTEM
Building Department - Doc Type
Permit
Permit #
18-20002
Building Department - Name
ADVENTIST HEALTH SYSTEM
Address
7350 DAIRY RD
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813-780-0020 C;+,v, of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received — Phone Contact for Permit <br /> _ — u— - --_ <br /> Owner's Name Z � s Owner's Phone Number <br /> 2 r Owner's Address � <br /> Fee Simple Titleholder Name <br /> Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address Lot# <br /> Sub Division Parcel# <br /> Bio-Hazard Waste Storage-ANNUAL Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> Controlled Burn Hood Installation <br /> Emergency Generator<30 kw LP/Natural Gas-Installation <br /> Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL <br /> fUEqy P—emil V7n ter <br /> Sprinkler El ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ Sparklerswt <br /> 2 <br /> Hood Cleaning El ❑ ❑ ❑ Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ Standpipes(Sprinkler Sys) 79 <br /> Fire Alarm Installation Torch Roofingfrar Kettle <br /> Fire Pumps Waste Tire Storage ANNUAL <br /> Flammable Application-ANNUAL "Z Q (J p Q Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> Contractor Company N' vstzy <br /> Signature Registered Y/N I Fee Current I Y/N <br /> Address License# Q <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current I Y/N <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current I Y/N <br /> Address License# <br /> OTHER Company c, <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License777 <br /> # <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />
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