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11-11753
Zephyrhills
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11-11753
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Last modified
2/8/2012 11:44:33 AM
Creation date
2/8/2012 11:44:32 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
11-11753
Building Department - Name
MEALS ON WHEELS
Address
38145 15TH AVE
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' 813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Perrnit 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 C� �� �� <br /> Fee Simple Titleholder Address <br /> ' �a �...,,;. ; .. _ . . . . , ;�,,,,� d ,: , ._ � , , <br /> Job Address � � j-� • Lot # �� <br /> �J <br /> Sub Division Parcel # <br /> � Bio-Hazard Waste Storege - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier il or Fac�lity) AN t�j <br /> � Controlled Bum � Hood Installation � / <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation � � "" " � � <br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> � emi � er <br /> Sprinkler � ❑ O ❑ � � Recreational Bum � ' <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers � <br /> Hood Cleaning ❑ ❑ ❑� � Sprinkler System Instaliations <br /> Hood Suppression ❑ � ❑ Standpipes (Sprinkler Sys) <br /> � Fire Alartn Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL � � Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> Contractor Company T�K ���y,,,� 7� LG � <br /> Signature Registered / nl Fee Current N <br /> Address License # G Opp�/g S� <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 /> MECHANICA Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER <br /> 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 (http://appraiser.pascogov.com) <br />
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