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11-11998
Zephyrhills
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11-11998
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Last modified
3/30/2012 11:36:33 AM
Creation date
3/30/2012 11:36:32 AM
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Building Department
Company Name
FLORIDA HOSPITAL OF ZEPHYRHILLS
Building Department - Doc Type
Permit
Permit #
11-11998
Building Department - Name
FLORIDA HOSPITAL OF ZEPHYRHILLS
Address
7050 GALL BLVD
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8 � s-7so-aozo City of Zephyrhills Fire <br /> Permit Appiication F�'813-780-0021 <br /> Date Receivftd �' I ��� Phone Contact fnr Permit 4! G,�j <br /> a �3s <br /> Owners Name y � s�n� � jj '[� S Owner's Phone Number ��.+ 7 <br /> � 7/! C� 8 3 �f8 <br /> Owner's Add�ess /[JSo ,QCL f�l,�r.� � 'L�3" L, �3sY�� <br /> Fee Simple T�tleholder Name Titleholder Phone Number ��� � <br /> Fee Simple T"�tlehoider Address <br /> Job Address � <br /> Lot # <br /> Sub Division - <br /> Parcel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct Hazardous Material <br /> � � (Tier II or RQ Facility) ANNUq� <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 /> � t y emi � t er ❑ (,�• /� Q� <br /> ( � �I (/ <br /> Sprinkler ❑ ❑ Recreational Bum � � <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alarm installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Fiammable Application- ANNUAL <br /> � � Valuation of Project <br /> Fuel Tanks <br /> Q Other• <br /> M� �:. � �:;::���: �:��� _ <br /> Contractor �. <br /> Signature - - <br /> Company i�y <br /> Registered Y/ Fee Current Y/ N <br /> Address <br /> License # <br /> ELECTRICIAN <br /> � Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> PLUMBER <br /> Signature <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> MECHANICAL <br /> Signature <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> OTHER <br /> Signature <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> �'��_� < License # <br /> '' � ' • " � � , c..x�� - � - �.::..x.�.M.wcaam�:��w:�:;- .o,.. ._ �.�•� -.; --. <br /> Directions: . �. �e�:.,.;:�:�.�-��,.,-�-�.:,:�.,„..,W.... <br /> ..a .,�.�e �.,. ���::35.,��,:,�a���.�"��'°a'3'�».'i�:a��� <br /> Fill out application completety <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 1 D-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />
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