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09-9740
Zephyrhills
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2009
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09-9740
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Last modified
1/10/2011 10:50:22 AM
Creation date
1/10/2011 10:50:21 AM
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Building Department
Company Name
PEDIATRIC PARTNERS
Building Department - Doc Type
Permit
Permit #
09-9740
Building Department - Name
PEDIATRIC PARTNERS
Address
6712 DAIRY RD
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813- 780 -0020 City of Zephyrhills Fire 41/P <br /> "7 q0 Fax -813- 780 -0021 <br /> Permit Application <br /> Date Receivea 1 I Phone Contact for Permit I li z I.14 2 I_ I ‚q C/ <br /> Owner's Name �� ignI r Owner's Phone Number I I I <br /> Owner's Address Al 'WAMir. 335 <br /> Fee Simple Titleholder Name Titleholder Phone Number I I I <br /> Fee Simple Titleholder Address <br /> Job Address S/ 7/-1 PG: 7 ed. 2I' k k// c/ 33 - V Lot# 1 <br /> Sub Division <br /> Parcel # <br /> I I Bio- Hazard Waste Storage - ANNUAL I I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I Comm Exhaust Kitchen Hood /Duct I I Hood Installation <br /> I I Controlled Burn n LP /Natural Gas - Installation <br /> I I Emergency Generator < 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> I I Emergency Generator > 30 kw I — I Places of Assembly- ANNUAL <br /> 1 XI Fire Protection Maintenance - ANNUAL I Recreational Burn <br /> (Qtrly) (Semi Other <br /> Sprinkler u ❑ ❑ ❑ I I Sparklers <br /> Fire Alarm Y ❑ ❑ I 1 I I Sprinkler System Installations <br /> Hood Cleaning Li ❑ ❑ 0 I 1 1 1 Standpipes (Sprinkler Sys) <br /> Hood Suppression Ell ❑ ❑ ❑ I I I I Torch Roofing /Tar Kettle <br /> 7 Fire Alarm Installation I Waste Tire Storage ANNUAL <br /> I — I Fire Pumps <br /> I - I Fire Works <br /> Flammable Application- ANNUAL 1 I Valuation of Project <br /> f 1 Fuel Tanks <br /> [ ] Other: I <br /> Contractor <br /> I ' Company A r 4,, 0 1 So (u 3- , r„C, I <br /> Signature i Registered Y / N Fee Current <br /> 1 IY /NI <br /> Address 1 35 31 11a J eane. Rd, <br /> `'I I License# I EFOOOptiy <br /> ELECTRICIAN Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address 1 I License # <br /> PLUMBER I Company <br /> Signature 1 Registered Y/ N J Fee Current I Y/ N I <br /> Address I License # I <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current 1 Y / N I <br /> Address 1 <br /> I License # <br /> OTHER <br /> Company <br /> Signature Registered Y / N Fee Current I Y / N I <br /> Address I I License # I I <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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