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11-11610
Zephyrhills
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Building Department
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2011
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11-11610
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Last modified
12/15/2011 9:07:20 AM
Creation date
12/15/2011 9:07:19 AM
Metadata
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Building Department
Company Name
DAUGHTERY ROAD PROFESSIONAL CENTER
Building Department - Doc Type
Permit
Permit #
11-11610
Building Department - Name
DAUGHTERY ROAD PROFESSIONAL CENTER
Address
37914 DAUGHTERY RD
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s1 s-�so-oo2o Ciry of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit �� �� <br /> Owners Name fJ►i'i T I� CNT Owners Phone Number �� � <br /> Owner's Address 7� 1.Vr 2 P� W �<<' ��` �' <br /> Fee Simple Titleholder Name Titleholder Phone Number �� � � <br /> Fee Simple Titleholder Address <br /> = r .:f' �:,:. <br /> Job Address 79 � 7 � � •• � Lot # � <br /> Sub Division Paroel # <br /> a Bio-Hazard Waste Storege - ANNUAL � Fumigation Tent <br /> a Comm 6chaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale �J <br /> � / � C/ <br /> Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL � I C � <br /> � emi �n er � �' <br /> Sprinkler � ❑ ❑ � � Recreational Bum � <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alartn Installation � Toroh Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL �--� Valuation of Project <br /> � Fu I Tanks <br /> Q O er: <br /> Contractor Company rJ <br /> Signature � Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Compa�y <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> Directions: <br /> Fill out application completely <br /> Owner 8 Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> If over $2500, a Notice of Commencement is required (Mechanical woric 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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