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11-11403
Zephyrhills
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2011
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11-11403
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Last modified
10/18/2011 2:23:53 PM
Creation date
10/18/2011 2:23:52 PM
Metadata
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Building Department
Company Name
FIRST UNITED PENTECOSTAL
Building Department - Doc Type
Permit
Permit #
11-11403
Building Department - Name
FIRST UNITED PENTECOSTAL
Address
5840 18TH ST
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813 - 780 -0020 City of Zephyrhills Fire Fax- 813 -780 -0021 <br /> Permit Application <br /> ate Received I Phone Contact for Permit I I .1 I I <br /> wner's Name 1 4 11 ks T (Ju T0o quif Co ST AL.. e MUk• N e t IQ(.' I Owner's Phone Number I I <br /> wner's Address 1 Se -t-j, <br /> O /g' SIX eer <br /> :e Simple Titleholder Name I Titleholder Phone Number I I I <br /> ae Simple Titleholder Address I <br /> )b Address I Lot # <br /> Jb Division I Parcel # I <br /> n Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> El Comm Exhaust Kitchen Hood /Duct Ti Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> [ ] Controlled Bum Ii Hood Installation <br /> n Emergency Generator < 30 kw El LP /Natural Gas - Installation <br /> El Emergency Generator> 30 kw El LP /Natural Gas - ANNUAL Sale <br /> I—I Fire Protection Maintenance - ANNUAL WI Places of Assembly- ANNUAL <br /> ry 'Semi' Wu MM. <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm 0 ❑ ❑ ❑ I I Sparklers <br /> Hood Cleaning 0 ❑ ❑ ❑ I I I Sprinkler System Installations <br /> Hood Suppression 0 ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> El Fire Alarm Installation I1 Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> E Fire Works <br /> E Flammable Application- ANNUAL I I Valuation of Project <br /> Ii Fuel Tanks <br /> 0 Other: 1 <br /> Dntrector Company I <br /> gnature � ' t`t. t' ScJ dkaL Registered Y / N I Fee Current I Y / N I <br /> Address I I License # <br /> _ECTRICIAN Company I <br /> gnature I Registered Y / N 1 Fee Current 1 Y/ N I <br /> Address I I License # <br /> _UMBER Company <br /> gnature Registered Y/ N 1 Fee Current I Y/ N I <br /> Address I I License # ( I <br /> ECHANICAL Company I <br /> gnature Registered Y/ N j Fee Current I Y/ N I <br /> Address I I License # I I <br /> THER Company <br /> gnature Registered Y/ N 1 Fee Current I Y/ N <br /> Address I <br /> 1 License # <br /> rections: <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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