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09-9898
Zephyrhills
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2009
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09-9898
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Last modified
1/11/2011 9:34:56 AM
Creation date
1/11/2011 9:34:55 AM
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Building Department
Company Name
ELKS LODGE
Building Department - Doc Type
Permit
Permit #
09-9898
Building Department - Name
ELKS LODGE
Address
851 WIRE RD
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813- 780-0020 City of Zephyrhiils - Fire Fax- 813 -780 -0021 <br /> Permit Application <br /> id y J <br /> , Date Received,._ :� - ..._. �.:,.:,_�±.., _. ,.. - _ , . - - .,_ _. Phone contact forf?errnit I ( I <br /> Owners Name / A U T O � E R F , .. 7 I . Owners Phone Number 31 1 02 1 l /6041 <br /> owners Address I Z,83 A.9 l ge '7,944 2rAy,' h i/S EL <br /> Fee Simple Titleholder Name I I Titleholder Phone Number I 1 1 I <br /> Fee Simple Titleholder Address I <br /> Job Address I Lot # I <br /> Sub Division I I Parcel # I <br /> Bio- Hazard Waste Storage - ANNUAL Fumigation Tent <br /> El Comm Exhaust Kitchen Hood/Duct I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> Emergency Generator < 30 kw iP/Natural Gas - Installation <br /> I I Emergency Generator > 30 kw I ' LP/Natural Gas - ANNUAL Sale <br /> Ej Fire Protection Maintenance - ANNUAL I I Places of Assembly - ANNUAL <br /> ® ® ® tither <br /> Sprinkler LI ❑ ❑ ❑ I I Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I I Sparklers <br /> Hood Cleaning ❑ ❑ ❑ I n Sprinkler System Installations <br /> Hood Suppression ❑ /'t ❑ I ( om I I Standpipes (Sprinkler Sys) <br /> ED Fire Alarm Installation r--] Torch Roofing/Tar Kettle <br /> ` Fire Pumps F 1 Waste Tire Storage ANNUAL <br /> Are Works <br /> Flammable Application - ANNUAL I , Valuation of Project <br /> Fuel Tanks <br /> Q Other. I <br /> Contractor Company <br /> Signature Registered Y/N I Fee Current I Y/N I <br /> Address I I License # I <br /> ELECTRICIAN Company I <br /> Signature Registered Y/N I Fee Current I Y/N I <br /> Address I I License # <br /> PLUMBER Company I <br /> Signature Registered Y/N 1 Fee Current I Y/N 1 <br /> Address I I License # I <br /> MECHANICAL Company <br /> Signature Registered YIN J Fee Current I Y/ N I <br /> Address I I . License # I <br /> O Company - <br /> Signature e ,�LG- e.(.tit/L- L <br /> Registered Fee Current <br /> Address <br /> Directions: <br /> - r <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 /Iappraiser.pascogov.com) <br />
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