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11-11410
Zephyrhills
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2011
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11-11410
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Last modified
10/18/2011 2:28:05 PM
Creation date
10/18/2011 2:28:04 PM
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Building Department
Building Department - Doc Type
Permit
Permit #
11-11410
Building Department - Name
ZEPHYR PLACE LLC
Address
6834 GALL BLVD SUITE 101
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813 - 780 -0020 City of Zephyrhills Fire Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received 1 /7/1/// I Phone Contact for Permit J 613 1 I ?9 11 qqq <br /> Owner's Name (- / ai5 A ZZ.a_, I Owner's Phone Number 6/3 2. /D <br /> I 11 �8 � <br /> Owner's Address 6 s 3 V ( ( a/ad 2 / t /4. 33-5-1/2- <br /> Fee Simple Titleholder Name I Titleholder Phone Number 1 1 I <br /> Fee Simple Titleholder Address <br /> Job Address b D 3 7 6-al/ gl (/I 2/ /7 ,S 3 3 <br /> Lot # <br /> Sub Division I 1 Parcel # I <br /> a Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> 0 Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> 0 Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale i' 41 <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL ` <br /> El � a- <br /> � !Semi! <br /> Sprinkler ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm 0 ❑ ❑ ❑ ( I n Sparklers <br /> Hood Cleaning 0 ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression E ❑ ❑ >9 1 J n Standpipes (Sprinkler Sys) <br /> El Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> 0 Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> Flammable Application- ANNUAL I 200 — I Valuation of Project <br /> a Fuel Tanks <br /> Q Other: I <br /> Contractor _ - - -- - <br /> Company <br /> Signatur= Registered Y / N I Fee ?S-.74)4,--", <br /> urrent 1 Y/ N 1 <br /> Address 1 P0 . 6 OCR 4244.d O `.4.2.A P 3'/639' 1 License # <br /> ELECTRICIAN Company <br /> Signature 1 Registered Y/ N I Fee Current I Y/ N I <br /> Address I ( License # <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current I Y / N I <br /> Address I <br /> License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current 1 Y/ N I <br /> Address I I License # <br /> OTHER <br /> Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address l 1 License # 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 $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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