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10-10924
Zephyrhills
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2010
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10-10924
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Last modified
8/15/2011 10:35:55 AM
Creation date
8/15/2011 10:35:55 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
10-10924
Building Department - Name
ROR LLC
Address
5130 GALL BLVD
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813= 780 -0020 City of.Zephyrhills Fire Fax - 813 -780 -0021 <br /> -Permit Application <br /> Date ReceiveLszta Phone Contact for Permit <br /> Owner's Name ) .4W1174-e. n/ I s Owner's Phone Number <br /> Owner's Address 573d a `r 3O i <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee SimpleTitleholder Address I <br /> Job Address S U N S -2 0/ <br /> Lot # <br /> Sub Division Parcel # <br /> n Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Controlled Bum Ln Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> El Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> ED Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> Fir d71 emr Other <br /> Sprinkler Ell ❑ ❑ ❑ n Recreational Bum 0 <br /> Fire Alarm n ❑ ❑ ❑ I 1 n Sparklers / <br /> Hood Cleaning n ❑ ❑ ❑ I n Sprinkler System Installatio s <br /> Hood Suppression 21 ❑ re ❑ I I n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle 0 <br /> n Fire Pumps n Waste Tire Storage ANNUAL /( <br /> n Fire Works (� <br /> 7 Flammable Application- ANNUAL <br /> 1 I Valuation of Project <br /> F T Fuel Tanks <br /> El Other: I <br /> Contractor �/��� � Company / 4/P . .f fA 1' <br /> Signature . -" Registered Y / N Fee Current N <br /> Address I 1 License # I <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N 1 Fee Current I Y / N j <br /> Address I I License #. <br /> PLUMBER Company <br /> Signature Registered Y/ N 1 Fee Current I Y/ N J <br /> Address 1 I ' License # I <br /> MECHANICAL Company <br /> Signature Registered Y/ N 1 Fee Current I Y/ N J <br /> Address 1 I License # I <br /> OTHER Company <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: /lappraiser.pascogov.com) <br />
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