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10-10017
Zephyrhills
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10-10017
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Last modified
1/26/2011 8:37:39 AM
Creation date
1/26/2011 8:37:38 AM
Metadata
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Template:
Building Department
Company Name
PUBLIX
Building Department - Doc Type
Permit
Permit #
10-10017
Building Department - Name
PRIMERICA GROUP ONE
Address
4838 GALL BLVD
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MAP, /28/2007 /WED 07:20 AM ZEPHYAHILLS BUILDING FAX No. 813 - 780 - 0021 �7 P. 001 <br /> 813-712-0—"-)• City of.Zephyrhills'Firi6= I1 61D Fax- 813 - 780-0021 l: <br /> • permit Application . - <br /> Date Received -Phone Contact for Permit itirgill <br /> ,.•,«t .. ykia EK rc } 20t <br /> Owner's Phone Number <br /> Owner's Name 4 �_ . �. - 0 : sew <br /> E� � 1 <br /> Owner's Address : • _ _ ' �a - ' <br /> Fee Simple Titleholder Name J T itleholder Phone Number 1 1 1 <br /> Fee SimplemtleholderAddress I w „ • <br /> Job Address %SS r elv , W , = • Lot # • - <br /> Sub Division Parcel # <br /> n Blo-Hazard Waste Storage - ANNUAL fl Fumigation Tent . <br /> E I . Comm Exhaust Kitchen Hood /Duct , • l l • Hazardous Material (Tier 11 or RQ Facility) ANNUAL <br /> Controlled Bum n Hood Installation <br /> I 1 Emergency Generator < 304tw 1 ` LP /Natural Gas- InstallaUon ' <br /> ' I I ''Emergency Generator> 30 kw 71 LP/Natural Gas- ANNUAL Selo , <br /> F1 Fire Protection Maintenance - ANNUAL . f] Places of Assembly- ANNUAL - <br /> l:e144 !berm' pil Vtner <br /> Spr r,de —R- -? ❑ ❑ Reoreational Bum . <br /> Fire Alarm 7 . ❑ 0. ❑ I 7 Spenders _ <br /> Ho... ._= I. - ∎�• SprinkerSystemInstallations <br /> Hoo• = uppression IT ID pi ❑ . LI Standpipes (Sprinkler Sys) - 1, 1 �7 • <br /> Fire Alarm Irietellafion Torch Roofing/Tar Kettle , ...� .-.` ���� <br /> • In Fire Pumps -- • Waste Tire Storage ANNUAL . <br /> • <br /> Fire Works ' <br /> 1 12510 <br /> Flammable Application- ANNUAL .1 - Valuation of Project <br /> Fuel Tanks <br /> ® Other: - <br /> Contractor • Company _ • 1 >1J ii _ •..i _ At <br /> Signature •_ ; erg . _ Registered Lamm Fee Current NMI <br /> Address w iv rera mtj j won1isarI I ns' - tt i # <br /> ELECTRICIAN Company I <br /> Signature • . Registered - Y / N • I Fee Current. . Y / N I <br /> ' 'Address; L ] License # I <br /> PLUMBER- ';t Company I <br /> Signature Registered Y /'N I Fee Current I Y/ N I <br /> Address License* • • I 1 <br /> MECHANICAL' Company 1 <br /> Signature Registered Y/ N I Fee Current I Y/ N <br /> Address I Lieenae # I • 1 <br /> OTHER . Company I <br /> Signature Registered Y/ N 1 Fee Current 1 Y/ N 1 <br /> Address • License* <br /> .... ti.._r,:,... - ..rn.,- .. r,:r^r: ro+e;aw:n.. ,.,. �^- . ?...., ✓--•.. ...e rn^*nn+u.ar_zn^!+. woo a. n:: rcw+-- a...,uayc.•�•rr- .r.:•....., n..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 $6000) <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 (httpJ /appraiser.pascogov_com) <br /> • <br />
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