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09-9961
Zephyrhills
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2009
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09-9961
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Last modified
1/11/2011 11:26:42 AM
Creation date
1/11/2011 11:26:42 AM
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Building Department
Company Name
ZEPHYR HAVEN NURSING HOME
Building Department - Doc Type
Permit
Permit #
09-9961
Building Department - Name
ZEPHYR HAVEN NURSING HOME
Address
38250 A AVE
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81378o-00213 City ofZephyrhillS Fire; Fax - 813 -780 -0021 <br /> Permit Application <br /> Date Received J _ <br /> Ph on Contact for Permit I <br /> Owner's Name S TMPT,RXGRTNNET,L Owners Phone Number 813 626 5 4 8 2 <br /> Owners Address 4701 Oak Fair Blvd TAMPA FL 33610 <br /> Fee Simple Titleholder Name - ' Titleholder Phone Number , <br /> Fee Simple Titleholder Address <br /> r`> a::^"��"`- .�'s:.T.. _. �� m ;��,�- ,_...�.zUK'.����. .-� ...�:0 - .sue 2 c� 1 <br /> Job Address 7 2 J () �. P,Ph�� I(� ► +� S r-- S J 3 I Lot # <br /> Sub Division Parcel # <br /> ro <br /> I • Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> I Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier If or RQ Facility) ANNUAL <br /> I Controlled Bum I Hood Installation <br /> 1 1 Emergency Generator < 30 kw I_ LP /Natural Gas - Installation <br /> I .. I Emergency Generator > 30 kw I LP /Natural Gas - ANNUAL Sale <br /> I I • Fire Protection Maintenance - ANNUAL I Places of Assembly- ANNUAL <br /> Iutrlyf 'Semi( (Anti <br /> Sprinkler. ❑ ❑ ❑ - 1 1 Recreational Burn <br /> , Fire Alarm ❑ ❑ it I I I ( Sparklers <br /> Hood Cleaning I D ❑ ❑ I I I ( Sprinkler System installations <br /> . . • .. Hood Suppression I ❑ ❑ ❑ I ) I I Standpipes (Sprinkler Sys) <br /> In Torch RoofingfTar Kettle - <br /> • 1 Fire Alarm Installation 1 : _.. <br /> (. I Fire Pum p s I • I Waste Tire Storage ANNUAL <br /> • I Fire Works • . <br /> I Flammable Application- ANNUAL 1 .1 Valuation of Project <br /> II <br /> Fuel Tanks • <br /> I • I Other: . I • <br /> ,••<�;s„,rx "::ar�aawS�ae�r. . �� ,: . H.a'.:.:ar•- °- :.,'�r:, s��.�+ �n rr�-4,Sa m ., ��� ��;�.s�-= �: <br /> Contractor Company 3 (J 7' Ki rnieti. 1( <br /> Signature Registered Y / N Fee Current I• Y / N I <br /> Address I <: rS` I License it I I <br /> ELECTRICIAN ompany •. <br /> C <br /> Registered • Y / N I -.Fee. C urrent I Y/ N <br /> Signature � = 9� , .; . <br /> Address 1 I License # I I <br /> PLUMBER Company <br /> Signature Registered Y / N - I Fee Current I Y / N: I <br /> Address I I License # - • .. I <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current Y / N - I <br /> Address I. I License # I I <br /> OTHER _ • Company - <br /> Signature Registered Y/ N I Fee Current I Y / N <br /> Address License # <br /> ° I o <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 /> • <br />
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