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11-11751
Zephyrhills
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2011
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11-11751
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Last modified
2/8/2012 11:43:23 AM
Creation date
2/8/2012 11:43:23 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
11-11751
Building Department - Name
CHATTERBOX CAFE
Address
5014 GALL BLVD
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` a� aaso-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Pertnit ��� � <br /> Owners Name Owners Phone Number ��� <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> Job Address � Lot # � <br /> Sub Division Parcel # <br /> � BiaHazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) AI�Nk1AL <br /> � Controlled Bum � Hood Installation � <br /> � Emergency Generator < 30 kw � LP/Naturai Gas-Installation J J/�� � <br /> � Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL e /� � <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUA <br /> r y emi �n er <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum <br /> Fire Alartn � ❑ ❑ O � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ � ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alartn Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire 5torage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> Contractor Company .Sp��, ` c r .�..�7 LL � <br /> Signature � Registered / N Fee Current N <br /> Address License # �+y� qp{//Q�(� <br /> ELECTRICIAN Company <br /> Signature I 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 & 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 (httpJ/appraiser.pascogov.com) <br />
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