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12-12854
Zephyrhills
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2012
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12-12854
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Last modified
2/5/2013 2:13:41 PM
Creation date
2/5/2013 2:13:41 PM
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Building Department
Company Name
LONG JOHN SILVERS, INC
Building Department - Doc Type
Permit
Permit #
12-12854
Building Department - Name
LONG JOHN SILVERS, INC
Address
7441 GALL BLVD
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s�saao-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> ate Received ��—� Pho�e Contact for Pertnit �� � �� <br /> �. <br /> wners Name l} � � Owners Phone Number � � � <br /> wner's Address � <br /> 3e Simpie Titleholder Name TiUeholder Phone Number � C� �� <br /> 3e Simple Titleholder Address <br /> >b Address Lot# � <br /> �b Division Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL Q Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sate /`/ <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL �u��7 <br /> ❑�y emi � er ( �/ <br /> Sprinkler ❑ ❑ ❑ � � Recreational Bum � <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning ❑ (� ❑ � a Sprinkler System Installations <br /> Hood Suppression ❑ ❑ O � � Standpipes(Sprinkler Sys) <br /> � Fire Alartn Installation � Torch RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> aFire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other. <br /> mtractor /1 r Company [ � <br /> gnature � Registered Y/N Fee Current �Y/N <br /> Address License# <br />.ECTRICIAN Company <br /> gnature � Registered Y/N Fee Current Y/N <br /> Address License# <br />_UMBER Company <br /> gnature Registered Y/N Fee Currerrt Y/N <br /> Address <br /> License# <br />=CHANICA <br /> Company <br />�nature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br />-HER <br /> Company <br />�nature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> ections: <br /> Fill out application completely <br /> Owner&Contractor sign back of appiication,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. Par�el#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />
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