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10-10567
Zephyrhills
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2010
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10-10567
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Last modified
2/2/2011 9:28:00 AM
Creation date
2/2/2011 9:27:59 AM
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Building Department
Company Name
QUALITY INN
Building Department - Doc Type
Permit
Permit #
10-10567
Building Department - Name
QUALITY INN
Address
6815 GALL BLVD
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813- 780 -0020 City of.Zephyrhills 'Fire - • . - Fax -813 -780 -0021 <br /> Permit Application <br /> Date Received - Phone Contact Permit <br /> Owner's Name (91,re m 60 / Owner's Phone Number I I I ._I I <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number I I I <br /> Fee Simple Titleholder Address <br /> �� � <br /> Job Address e pp JC // 4 / Z1G 7 1'// / /iA 3$5V/ Lot# ( <br /> Sub Division Parcel # <br /> Bio-Hazard Waste Storage - ANNUAL n <br /> El Fumigation Tent <br /> n Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> F - 1 Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> .� )(Arty( I Semi l raj Inner - <br /> Sprinkler ❑ ❑ n Recreational Bum <br /> Fire Alarm E ❑ ❑ ❑ I I n Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I I n Sprinkler System Installations <br /> • <br /> Hood Suppression E ❑ ❑ ❑ I ( n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation - n Torch Roofing/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application - ANNUAL I I Valuation of Project <br /> Fuel Tanks <br /> Q Other: I <br /> Contractor Company <br /> Signature Al- Registered Y / N ] Fee Current I Y / N J <br /> Address 1 License # I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N j Fee Current I Y/ N <br /> Address I I License # I I <br /> PLUMBER Company I <br /> Signature Registered Y/ N 1 Fee Current I Y/ N J <br /> Address I I License # I <br /> MECHANICAL Company <br /> Signature Registered Y / N J Fee Current 1 Y / N j <br /> Address I I License # I <br /> OTHER Company I <br /> Signature Registered Y/ N 1 Fee Current 1 Y/ N I 1 <br /> Address ^ `��„ I 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 (httpJ /appraiser.pascogov.com) <br />
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