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11-12539
Zephyrhills
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2011
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11-12539
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Last modified
6/18/2012 3:16:47 PM
Creation date
6/18/2012 3:16:46 PM
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Building Department
Company Name
FLORIDA MEDICAL CLINIC
Building Department - Doc Type
Permit
Permit #
11-12539
Building Department - Name
FMC MARKET SQUARE INC
Address
38051 MARKET SQUARE DR
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813-780-OD20 City ofZephyrhills�Fir�e• FaX-a�aaao-oo2i <br /> Permit Appiication <br /> � � ._ _ <br /> Date Received � Phone Contactfor Permit <br /> Owner's Name Q ("� ` �1 � � Owners Phone Number -� �. � <br /> Owners Address QJ � � � <br /> Fee Simple Titlehoider Name Titleholder Phone Number ��� <br /> Fee Simple Tttleholder Address <br /> JobAddress � � C, � I 335y� Lot# � <br /> Sub Division Paroel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen HoodlDuct � Hazardous Material �er II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> a Emergency Generator < 30 kw � LPMatural Gas-Instaliation <br /> � Emergency Generator> 3D kw � LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Mairrtenance - ANNUAL � Places of Assembly-ANNUAL <br /> �y emi �n er � � <br /> 5prinkler � ❑ ❑ ❑ � Recreationai Bum � / � <br /> Fire Alartn ❑ ❑ �Z � � Sparklers ' � <br /> Hood Cieaning g❑ ❑ ❑ C� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> Fire Pumps � Waste Tira Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL Valuation of Project <br /> Fuei Tanks <br /> Q Othe � <br /> ConUactor Company Q �� <br /> Signature Registered Y/ N Fee Cu nt Y/ ��bUo <br /> 1 <br /> Add�ess License # <br /> ELECTRICIAN Company <br /> Signature " Registered Y/ N Fee Currant 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/ N Fee Curtent Y/ N <br /> Address License # <br /> OTHER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> Wsr.��� i �f'rwu�.teranu m�r�sr�mtmnil <br /> Directions: <br /> FII out appiication compietely. <br /> Owner 8 Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> tf 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 #- obiained from Property Tax Notice (httpJ/appraiser.pascogov.com) <br />
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