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11-12521
Zephyrhills
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11-12521
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Last modified
6/18/2012 3:03:52 PM
Creation date
6/18/2012 3:03:51 PM
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Building Department
Company Name
SILVER OAKS VILLAGE
Building Department - Doc Type
Permit
Permit #
11-12521
Building Department - Name
CERVALLOS,JUAN
Address
6215 ABBOTT STATION DR 101
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s��-7ao-aa2o City of Zephyfiilts'Fi� Fax-813-780-0021 <br /> Perrnit Application � <br /> )ate Received - Phone Contaet for Pertnit �� <br /> :�s�v�x��,. ,,.�.,,...,�. �..�.�.....�� ...K...�,�... .. _.. � <br /> hmer's Name Y1 �4` l� � 1 �� S Owne�s Phone Number ��� <br /> )wners Address � <br /> 'ee Simple T�leholder Name Titleholder Phone Number ��� <br /> =ee Simple TiUeholder Address <br /> ` _��?:�."'?��� <br /> Job Address p U}� �" � L) (D 2 I.5 Lot # � <br /> Sub Division � `�� Paroel # � – '" �� (� � G p <br /> �a� ����� <br /> � Bio-Hazard Wasie 5torage - ANNUAL � FumigaUon Tent <br /> � Comm Exhaust Kltchen HoodlDuct � Hazardous Matedal (Tier II or RQ Faclliiy} ANNUAL <br /> a ConVolled Bum � Hood Installatlon <br /> � Emergsncy Generatar < 30 kw � LP/Natural Gas-Installation <br /> Emergency Generator> 30 kw � LPlNatural Gas-ANNUAL Sale �- �� � - <br /> Flre Protection Mai�enance - ANNUAL a Places of Assembly-ANNUAL ��/' <br /> �y em� AT er � <br /> 5prinkier � ❑ O O � � Recreatlonal Bum h / � � <br /> Fire Alartn ❑ ❑ }�] � � Sparklers ,[ I � C J ( � <br /> Hood Cleaning � ❑ O /❑ � � Sprinkler System installatlons �� ; (� � � / � <br /> Hood Suppression � ❑ ❑ O� � Standpipes (Sprinkler Sys) <br /> � Fire Afartn InstallaHon a Torcfi. RoofinglTar Kettle <br /> Fire Pumps � Waste Tira Storage ANNUAL <br /> Fira Wotics <br /> Ftammable Applicatlon-ANNUAL r Valuation of PrOjeCt <br /> Fusi Tanks <br /> Q Other. <br /> � <br /> Contractor Comparry -� � �.cr `�� �, <br /> Signature ' Registared Y N Fee Current N <br /> Address 1 _ � Licen9e # `J b i� <br /> ELECTRICIAN Company <br /> 5lgnature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Curtent Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y I N Fee Current Y/ N <br /> Address License # <br /> OTHER Company <br /> Slgnature Registared Y/ N Fee Current Y i N <br /> Address Ucense # <br /> -- -,..,.�. <br /> Direetions: •<•"� =-= a - — - • "' d i ^- � --_ "'�' - <br /> Fill out apptication completely. <br /> Owner 8 Contractor sign back of application, notarized (Or, copy of signad contract with owner) <br /> If over 325D0, a Notice of Commencement is required (Mechanip! work over 35000) <br /> Supply two (2) sets of drawings with applica6le dacumentation <br /> Allow 10-14 days for revtew after submittal date. Parcal #- obtai�ed from Property Tax Notics (http:Uappraiser.pascogov.com) <br />
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