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07-7335
Zephyrhills
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Building Department
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Permits
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2007
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07-7335
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Last modified
3/6/2009 4:31:53 PM
Creation date
1/18/2008 9:51:52 AM
Metadata
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
07-7335
Building Department - Name
WELLESLEY DEVELOPMEN
Address
5538 GALL BV
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<br />813-780-0020 City of Zephyr hills Fire <br />. / / Permit Application <br /> <br />;~~%:;:)~~~~_~~~L~/~2:mMML_d'__W~~~_~r P~~~~J.,.____JJ:_::1L,._,..wJ <br />I ? .-Ij-.QZ 0 fI~ {/7'I71f I Owner's Phone Number I II I J I <br />I Z3 Of ?oJt1 H:/JC I1jJl(/( Pi I <br />I I Titleholder Phone Number II II I <br />I I <br />I S-S-3 & <br />I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />Gfl LL <br /> <br />~LVO <br />I <br /> <br />Fax-813-780-0021 <br /> <br />L\ ~I,€- <br />i~ /2-.-z.../07 <br />Parcel # <br /> <br />c~~ <br /> <br />I Lot# <br /> <br />(U~ I AINt::U f-KUM t-'KUt-'t::K I Y I AX NU 11l;t::) <br /> <br />D <br />D <br />D <br />D <br />D <br />~ <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen HoodlDuct <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br /> <br />Sprinkler <br />Fire Alarm <br />~uppression <br />Fire Alarm Installation <br />Fire Pumps <br /> <br />D <br />D <br />0- Q(-\-~ <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br />Recreational Bum <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch Roofing <br />Waste Tire Storage ANNUAL <br /> <br />Other: <br /> <br />Valuation of Project <br /> <br />Fuel Tanks <br /> <br /> <br />Fire Works <br /> <br />Flammable Application- ANNUAL <br /> <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y I N I Fee Current <br /> <br />Contractor <br />Signature <br /> <br />Address I <br /> <br />ELECTRICIANI <br />Signature , <br /> <br />Address I <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature , <br /> <br />Address I <br /> <br />OTHER <br />Signature~ <br /> <br />Address <br /> <br />Directions: <br /> <br />Y/N <br /> <br />Company <br />Registered <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />Y / N I Fee Current <br /> <br />Y/N <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />,Y I N Fee Current <br /> <br />Y/N <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />100\ OQ.~ c.e....e.u l~ <br />Y I N I Fee Current Y I N <br /> <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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