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11-12479
Zephyrhills
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2011
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11-12479
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Last modified
6/12/2012 2:03:47 PM
Creation date
6/12/2012 2:03:46 PM
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Building Department
Company Name
BARBS RESTUARANT
Building Department - Doc Type
Permit
Permit #
11-12479
Building Department - Name
HUFFMAN,CARLYLE & BARBARA
Address
5017 GALL BLVD
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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit �� �� <br /> Own�r's Name � � ' P3� „f Owners Phone Number ��� ?d'� � <br /> Owner's Address $ � / � �,� �_ � � v � ��l , <br /> Fee Simple Titleholder Name TiUeholder Phone Number C� C� � <br /> Fee Simple Titleholder Address <br /> �.J <br /> Job Address Lot # C� <br /> Sub Division Parcel # <br /> � Bio-Hazard Waste Storege - ANNUAL a Fumigation Tent <br /> � Comm Exhaust Kitchen HoodlDuct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlied 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 /> ❑ [QTr y emi �n er ❑ <br /> Sprinkler ❑ ❑ ❑ Recreationai Bum <br /> Fire Alarm � ❑ ❑ ❑ C� � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ � ❑ �� � <br /> Standpipes (Sp�nkler Sys) <br /> � Fire Alartn Installation � Toroh Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> a Fire Works <br /> � Flammable Application- ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> Contractor � <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> ELECTRICIAN <br /> Compa�y <br /> Signature I Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> PLUMBER <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> MECHANICA <br /> Signature <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> OTHER <br /> Signature CompanY c' rt �� �G7�i����✓T �L� <br /> Registered Fee Current <br /> Address <br /> License # ' � � • � <br /> Directions: ' <br /> Fill out application completely. <br /> Ovmer & 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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