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21-1342
Zephyrhills
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Building Department
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2021
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21-1342
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Last modified
5/6/2022 1:37:39 PM
Creation date
5/6/2022 1:37:39 PM
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Building Department
Company Name
ST ELIZABETH'S EPISCOPAL CHURCH
Building Department - Doc Type
Permit
Permit #
21-1342
Building Department - Name
ST ELIZABETH'S EPISCOPAL CHURCH
Address
5855 16TH ST
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813-780-0020 '44 City of Zephyrhills Fire Fax <br /> Permit Application <br /> Date Received <br /> Phone Contact for Permit <br /> Owner's Name � ners Phone Number <br /> Owners Address c f "V <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address <br /> Lot# <br /> Sub Division Parcel# <br /> 1:1 1 NOME <br /> 0 Blo-Hazard waste Storage-ANNUAL Q Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier 11 or RQ Facility)ANNUAL <br /> Controlled Bum Hood Installation <br /> F-1 Emergency Generator<30 kw LP/Natural Gas-Installatior <br /> M Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale <br /> E-1 Fire Protection Maintenance-ANNUAL EFV Places of Assembly-ANNUAL <br /> M Us"e-Mi 1 Other <br /> Sprinkler El 0 C1 n F-1 Recreational Bum <br /> Fire Alarm F-1 11 11 0 [--J Sparklers <br /> Hood Cleaning 0 0 0 Sprinkler System Installations <br /> Hood Suppression 0 0 0 F7 Standpipes(Sprinkler Sys) <br /> oFire Alarm Installation Torch Roofingrrar Kettle <br /> Fire Pumps Waste Tire Storage ANNUAL <br /> 8Flammable Application-ANNUAL Valuation of Project <br /> FuelTanks <br /> ther: <br /> Contractor <br /> Company <br /> Signature Registered Y/N' Fee Current nY NLj <br /> Address License# <br /> ELECTRICIANI Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current N <br /> Address License# <br /> MECHANICALI Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# F- <br /> OTHER Company <br /> Signature F Registered Y N Fee Current L_X/N J <br /> Addres <br /> s License <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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