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11-11468
Zephyrhills
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2011
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11-11468
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Last modified
10/19/2011 1:34:55 PM
Creation date
10/19/2011 1:34:55 PM
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Building Department
Company Name
UNITED METHODIST CHURCH
Building Department - Doc Type
Permit
Permit #
11-11468
Building Department - Name
UNITED METHODIST CHURCH
Address
38635 5TH AVE
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813 - 780 -0020 City of Zephyrhills Fire Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received I I Phone Contact for Permit I 1 I 1 1 I <br /> 7Q Owner's Name r�� / _ / �!�/ ��. Owner's Phone Number 1 1 1 <br /> rn Owner's Address 7 '/�‘is .5' I <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I I <br /> Job Address 1 Lot # <br /> Sub Division I Parcel # I I <br /> 0 Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct = Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Controlled Bum n Hood Installation <br /> 0 Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> Emergency Generator > 30 kw n LP /Natural Gas - ANNUAL Sale <br /> El Fire Protection Maintenance - ANNUAL p Places of Assembly- ANNUAL <br /> M <br /> y !Semi GL11 �T`''' <br /> Sprinkler 0 ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I 1 n Sparklers <br /> Hood Cleaning 0 ❑ ❑ ❑ I 1 n Sprinkler System Installations <br /> Hood Suppression E ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> R Fire Pumps <br /> n Waste Tire Storage ANNUAL <br /> Fire Works <br /> ED Flammable Application- ANNUAL I I Valuation of Project <br /> El Fuel Tanks <br /> Q Other: I <br /> ` n ContractoL-- / Company <br /> N Signature i 6. an <br /> Y/ N 1 Fee Current I Y/ N I <br /> Addr I License # I I <br /> ELECTRICIAN Company I <br /> Signature I Registered Y/ N 1 Fee Current I Y/ N I <br /> Address I I License # ( I <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current 1 Y/ N I <br /> Address 1 I License # I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N I Fee Current 1 Y/ N I <br /> Address 1 I License # I <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I <br /> 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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