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11-11879
Zephyrhills
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2011
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11-11879
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Last modified
2/9/2012 1:19:11 PM
Creation date
2/9/2012 1:19:11 PM
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Building Department
Building Department - Doc Type
Permit
Permit #
11-11879
Building Department - Name
HUFFMAN,CARLYLE & BARBARA
Address
5017 GALL BLVD
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s i sz•eaoazo <br /> � City of.Zephyrhills�Fir.e FaX-aiaaso-oo2� <br /> M 7 Permit Application <br /> �'� -� �. a� i <br /> i✓ �` Phone Contact for Pertnit � <br /> �^-...� �__..:.as.�.t:,....�.,..„4.>:_.�..... <br /> late Received qu „ -�*� - ' '° - <br /> s �7",&:ii�-��..�,-.a�i:.F��'�"'�n ..e.�. �—�.:.—�.P« �- <br /> L ��� �� � Owners Phone Number ��� '��� • �� <br /> )wner's Name <br /> )wner's Address 71 �• ��'` ��� T��� �L 336'7� <br /> Titleholder Phone Number � C� � <br /> ee Simple Titleholder Name <br /> ee Simple Titleholder Address - " a«�'�. <br /> :..�°`'.��`�"� '.'�i "".�Z:'�s' ,�"` ` <br /> ob Address � <br /> B S �S TT R T �o� � �� <br /> �ub Division ���/ �/ ,�� �"'�D• Parcel # ,,, Y � ; <br /> � Bio-Hazarci Waste Storage - ANNUAL � Fumigation Tent <br /> a Comm Exhaust Kitchen Hood/Duct � Hazardous Matetial �er II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � � LP/Natu21 Gas-ANNUAL Sale �` <br /> Emergency Generetor > 30 kw <br /> a Fire Protection Maintenance - ANNUA� � Places of Assembly-ANNUAL <br /> y em� n er � <br /> 5prinkler � � � � � � Recreational Bum i� /� � <br /> 0 � 0 �� j!� <br /> Fire Alarm ❑ O ❑ 5parklers <br /> Hood Cleaning <br /> � � � ❑ � a 5prinkler System Instal�ation � <br /> Hood Suppression � ❑ � �� a Standpipes (Sprinkler Sys) <br /> � Fire Alartn Installation � Torch RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> a Fire Works <br /> a Flammable Application- ANNUAL Valuation of Project <br /> a Fue( Tanks <br /> a Other <br /> �ontractor � Company � <br /> 5ignature - '!i� """ Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature Registered Y/�1 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/ f�l Fee Current Y! N <br /> Address License # <br /> OTHER Company <br /> Signature Registered l� /�) Fee Current Y/(�l <br /> Address License # <br /> Directions: � <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed conGact with ov�mer) <br /> If over 52500, a Notice of Comme�cement is required (Mechanical work over $5000) <br /> Supply iwo (2) sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http:/lappra�ser.pascogov.com) <br />
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