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10-11055
Zephyrhills
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2010
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10-11055
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Last modified
8/16/2011 7:38:19 AM
Creation date
8/16/2011 7:38:19 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
10-11055
Building Department - Name
ABED,HAZEM G
Address
38445 5TH AVE
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- 813 -780 -0020 City of.Zephyrhills Fire Fax - 813 -780 -0021 <br /> - Permit Application <br /> Date Received d/JY /O Phone Contact for Permit I <br /> Owner's Name eiAllrilifo Q AM MT Owners Phone Number es Y7?-- , Voe. <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number , <br /> Fee Simple"Titleholder Address I <br /> *r � J w� . � f Lot # <br /> Job Address <br /> Sub Division Parcel # <br /> n Bio- Hazard Waste Storage - ANNUAL = Fumigation - Tent <br /> n Comm Exhaust Kitchen Hood/Duct I I Hazardous Material (Tier II or RC) Facility) ANNUAL <br /> El Controlled Bum n Hood Installation <br /> Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> 1E11( Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly -ANNU <br /> ItiFyi I emi Dm Other <br /> Sprinkler n ❑ ❑ ❑ n Recreational Burn / n_5'-`; <br /> Fire Alarm n ❑ ❑ ❑ 1 n Sparklers t� <br /> Hood Cleaning ❑ �7 I J n Sprinkler System Instal ' s Hood Suppression Efr0 <br /> ❑ (12" ❑ I J n Standpipes (Sprinkler Sys) i (] I <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle I `� <br /> Fire Pumps n Waste Tire Storage ANNUAL j v <br /> in Fire Works <br /> Flammable Application- ANNUAL I ( Valuation of Project <br /> Fuel Tanks <br /> Other: I <br /> Contractor Company >L /,r i.?_ 1l/ C. Signature Registered r' ) F = - Current Y / N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature I Registered Y / N I Fee Current I Y / N I <br /> Address I I License #. I <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N J <br /> Address I I . License # I <br /> MECHANICAL Company <br /> Signature Registered Y/ N 1 Fee Current I Y/ N I <br /> Address I 1 License # I I <br /> OTHER Company <br /> Signature Registered Y/ N 1 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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