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11-11755
Zephyrhills
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2011
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11-11755
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Last modified
2/8/2012 11:45:44 AM
Creation date
2/8/2012 11:45:43 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
11-11755
Building Department - Name
ADVENTIST HEALTH SYSTEM
Address
7350 DAIRY RD
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s��-�ao-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit C� ��� <br /> Owner's Name � Owner's Phone Number �� � <br /> Owners Address <br /> Fee Simple Titleholder Name TiUeholder Phone Number ��� <br /> Fee Simple Titleholder Address <br /> Job Address ��� �� ' Lot # � <br /> Sub Division Parcel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier il or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generetor > 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> �y em� �n er � <br /> �� / <br /> Sprinkler � ❑ O ❑ � Recreational Bum Q <br /> Fire Alarm � � ❑ ❑ � � Sparklers �G-, <br /> l `�� � <br /> Hood Cleaning �❑ � ❑� � Sprinkler System Installations <br /> Hood Suppression ❑ � ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation � Torch RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> a Flammable Application- ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> Contractor Company ' 7 �,g� Gc�7r,y �, � �L,e <br /> Signature Registered N Fee Current N <br /> Address License # G vGe� /� � <br /> ELECTRICIAN Company <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 /> MECHANICA 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 work over $5000) <br /> Supply two (2) sets of drawings with applicable documentation <br /> Allow 10-14 days for review afler submittal date. Parcel #- obtained from Property Tax Notice (http:!/appraiser.pascogov.com) <br />
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