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09-9155
Zephyrhills
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2009
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09-9155
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Last modified
1/13/2011 3:21:30 PM
Creation date
1/13/2011 3:21:29 PM
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Building Department
Company Name
BOY SCOUT HUT
Building Department - Doc Type
Permit
Permit #
09-9155
Building Department - Name
MILLER,HARRY E & MARY H
Address
4841 6TH ST
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813 -780 -0020 City of Zephyrhills Fire Fax -813 -780 -0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> _+ cn .. �yyp�R' wrfvu}'yawPbuAMnONRYttI <br /> Owner's Name I I Owner's Phone Number I 1 1 I I <br /> Owner's Address I <br /> Fee Simple Titleholder Name I I Titleholder Phone Number I I <br /> Fee Simple Titleholder Address I I <br /> Job Address I Lot# I <br /> Sub Division I I Parcel # I I <br /> ED Bio-Hazard Waste Storage - ANNUAL = Hazardous Material (Tier I1 or RQ Facility) ANNUAL <br /> E Comm Exhaust Kitchen Hood /Duct El Hood Installation <br /> El Controlled Bum n LP /Natural Gas - Installation o <br /> ED Emergency Generator < 30 kw - LP /Natural Gas - ANNUAL Sale 0.1 (/ "4 <br /> Emergency Generator> 30 kw \ .... Places ofAssembly- ANNUAL / 'v / r' <br /> Fire Protection Maintenance - ANNUAL III Recreational Bum U <br /> r WI LIU r� e i� <br /> Sprinkler El ❑ ❑ ID El Sparklers I OY <br /> Fire Alarm 0 ❑ ❑ ❑ I 1 El Sprinkler System Installations n <br /> Hood Cleaning Ej ❑ ❑ ❑ I I ED Standpipes (Sprinkler Sys) .J < 1344 <br /> Hood Suppression El ❑ ❑ ❑ I I = Torctr Roofing/Tar Kettle <br /> R Fire Alarm Installation Waste Tire Storage ANNUAL <br /> Fire Pumps <br /> Fire Works <br /> El Flammable Application- ANNUAL 1 1 Valuation of Project <br /> Fuel Tanks <br /> Q Other: I I <br /> :• .$ ., '"+:: .5., &Y.bi$3E3'l:A;; ✓,£$x ,.n;„5ijty,. C3-,,,E4.LFF- S*6i,. . hzry ?'S{^l'`.,.a` 'w�'{i.JY.I'.;fi' ..`3t'Y %a L..3"int:.x.ss,GY ae:..t? ,. ''n -'?4k? X33. a xAh. . �:: #..Ntl:z a'k6'RS; <br /> Contractor Company <br /> Signature Registered Y / N 1 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 I Fee Current I Y / N I <br /> Address I I License # I I <br /> MECHANICAL Company I <br /> Signature Registered Y / N I Fee Current I Y / N I <br /> Address I I License # I <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address License # <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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