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11-11445
Zephyrhills
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Building Department
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Permits
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2011
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11-11445
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Last modified
10/19/2011 9:37:49 AM
Creation date
10/19/2011 9:37:48 AM
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Building Department
Company Name
CHURCH OF CHRIST
Building Department - Doc Type
Permit
Permit #
11-11445
Building Department - Name
CHURCH OF CHRIST
Address
5444 4TH ST
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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> te Received , J Phone Contact for Permit <br /> . , <br /> /nes Name x, I hi..ki h o - P 0 I/ r'r 5± 1 Owner's Phone Number 18 I 3 11 "1 8 3 11 56.-2 1 <br /> iner's Address k_-.1 54 q ¥ q 4 54 <br /> / r -e. e± z - e 1 t k i F L. 3 3 5 <br /> 1.--- j I <br /> e Simple Titleholder Name I Titleholder Phone Number I I I <br /> e Simple Titleholder Address I I <br /> b Address Lot # <br /> lb Division I I Parcel # I 1 <br /> El Bio-Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> [1 Comm Exhaust Kitchen Hood/Duct = Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> = Controlled Bum pi Hood Installation <br /> E l Emergency Generator < 30 kw I LP/Natural Gas-Installation <br /> ri Emergency Generator > 30 kw 1 LP/Natural Gas-ANNUAL Sale <br /> = Fire Protection Maintenance - ANNUAL al Places of Assembly-ANNUAL <br /> q 5 <br /> RINI ISemi I raj Other <br /> Sprinkler 0 0 0 0 • Recreational Bum <br /> Fire Alarm El 0 0 0 I 1 71 Sparklers <br /> Hood Cleaning 0 0 0 0 1 1 7 Sprinkler System Installations <br /> Hood Suppression 0 0 0 0 1 1 7 Standpipes (Sprinkler Sys) <br /> El Fire Alarm Installation I Torch Roofing/Tar Kettle <br /> El Fire Pumps I Waste Tire Storage ANNUAL <br /> El Fire Works <br /> 1:1 Flammable Application- ANNUAL <br /> 1 1 Valuation of Project <br /> El Fuel Tanks <br /> = Other I I <br /> pritractoc„ . d C. Company I <br /> gnature Registered Y / N I Fee Current I Y / N .. I <br /> Address I License # <br /> _ECTRICIAN Company I <br /> gnature I Registered Y / N I Fee Current I Y / N I <br /> Address I License # I <br /> _UMBER Company I <br /> gnature Registered Y / N I Fee Current I Y / N <br /> Address I I License # I <br /> ECHANICAL Company I <br /> gnature Registered Y / N I Fee Current I Y / N I <br /> Address I I License # I <br /> THER Company <br /> gnature Registered Y / N I Fee Current I Y / N I <br /> Address I I License # I <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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