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07-7218
Zephyrhills
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2007
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07-7218
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Last modified
3/6/2009 4:32:16 PM
Creation date
1/17/2008 10:07:38 AM
Metadata
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Building Department
Building Department - Doc Type
Permit
Permit #
07-7218
Building Department - Name
HEALTH CARE PROPERTY
Address
6701 DARY RD
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<br />City of Zephyr hills Fire -+i-' 72/8 <br />Permit Application J7 <br />~~~ll~__~_t_'"____-LA. ll~ ~j _ ,ai' ;ho~~:a~~i~Or~ermit ~---ll0_._,","1L_~""'M_4J <br />Ilk~:rf b YOO k /Y1 PI i1 pr I Owner's Phone Number I II II <br /> <br />I 57tJI Dc,/r"1 teJ z~~h~vA;I/S H 3~S'~ <br /> <br />I <br />I <br /> <br />813-780-0020 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />Fax-813-780-0021 <br /> <br />I Titleholder Phone Number I <br /> <br />II <br /> <br />II <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />b7o/ De:;iy'j ;Q J <br /> <br />Parcel # <br /> <br />I Lot# <br /> <br />I q~;A~~ ~:~~~et=:~;,9;~:;'~\j~~ 0 <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood/Duct <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br /> <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br /> <br />~ --t~tcr <br /> <br /> <br />Hood Clean/Suppression D <br /> <br />Sprinkler <br /> <br />Fire Alarm <br /> <br />Fire Alarm Installation <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />D Fumigation Tent <br />D Hazardous Material (Tier II or RQ Facility) ANNUAL <br />D Hood Installation <br />D LP/Natural Gas-Installation <br />D LP/Natural Gas-ANNUAL Sale <br />D Places of Assembly-ANNUAL <br />D Recreational Bum <br />D Sparklers <br />D Sprinkler System Installations <br />D Standpipes (Sprinkler Sys) <br />D Torch Roofing <br />D Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />Other: <br /> <br /> <br />Contractor <br />Signature <br /> <br />Address I <br /> <br />ELECTRICIAN <br />Signature I <br /> <br />Address I <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANICAL! <br />Signature I <br /> <br />Address I <br /> <br />OTHER <br />Signature <br /> <br />Company I Cu')<; r-,.YG- j-JV~~~i7~ ~*" <br />Registered Y I N I Fee Current Y I N I <br />License # I I <br />Company I <br />Registered Y/N I Fee Current Y/N I <br />License # I <br />Company <br />Registered Y/N I Fee Current Y/N <br />License # <br />Company <br />Registered Y/N I Fee Current Y/N <br />License # <br />Company <br />Registered Y/N I Fee Current Y/N <br />License # <br /> <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. <br />
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