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11-12640
Zephyrhills
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Building Department
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Permits
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2011
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11-12640
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Last modified
6/20/2012 2:26:38 PM
Creation date
6/20/2012 2:26:37 PM
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Building Department
Company Name
WESTBROOK MANOR
Building Department - Doc Type
Permit
Permit #
11-12640
Building Department - Name
FLORIDA SENIOR PROPERTIES
Address
6701 DAIRY RD
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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> ate Received ,. Phone Contact for Pertnit � z�� �� i�7 !� <br /> wner's Name `' �� C'. 1 U V `'l '1 Owners Phone Numbe� � �� ! <br /> wner's Address b . � � ' 1 (' �O ' � . � � <br /> 3e Simpie Titleholder Name TiUeholder Phone Number �� � <br /> se Simple Titleholder Address <br /> �b Address Lot # � <br /> �b Division Paroel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> a Emergency Generator < 30 kw � LP/Natural Gas-Instaliation <br /> � Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL O <br /> �y emi �n er i � r � <br /> Sprinkler � O ❑ �� � Recreational Bum <br /> � � .�. <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning �❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alartn Installation � Toroh Roofing!(ar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> �ntractor _ Company <br /> gnature ' Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> _ECTRICIAN Company <br /> gnature I Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> .UMBER Company <br /> gnature Registered Y/ N Fee Curtent Y/ N <br /> Address License # <br /> =CHANICA Company <br /> �nature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> fHER Company <br /> �nature Registered Y/ N Fee Cument Y/ N <br /> Address License # <br /> rections: <br /> Fill out application completely. <br /> Owner & 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 applicabie documentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com) <br /> 9'_. <br />
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