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12-12908
Zephyrhills
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Building Department
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Permits
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2012
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12-12908
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Last modified
2/12/2013 11:39:47 AM
Creation date
2/12/2013 11:39:47 AM
Metadata
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Building Department
Company Name
PRIMERICA GROUP ONE
Building Department - Doc Type
Permit
Permit #
12-12908
Building Department - Name
PRIMERICA GROUP ONE
Address
7910 GALL BLVD
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ais-�ao-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br />)ate Received ..� / 5� / t Phone Co�tact for Permit <br />�v-,a. . _ � @� . . ..GPEG... .. ._ c�4pY#2+&?Y»i.-v.-a:.t$�° ."i�`r.'?'ia..u-,.rxrne.-_._ f-f'xv'e* .ai.mlvrt --:. .. .,..,.._. v .v . .: <br /> Tvner's Name �L� ��� Owner's Phone Number � � � <br /> h�vner's Address � T �V lj L L �� �� <br /> ee Simple Titleholder Name Titleholder Phone Number � � � <br />�ee Simple Titleholder Address <br />� - `�"�'',�y+ ��� .�•, �r~�• ,.«c� <br />�ob Address s �'"'�� Lot# p � <br />�ub Division Parcel# <br /> e -ex-�^� <�.e::�:n a. .�n _ .. . . . -'�R . _ . .,_ a.w»,ri'�aryw; .� _ , �� �a��':� ,.•_`�d�'.L�3-:P - - <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct a Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw Q LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Mai�tenance-ANNUAL � Places of Assembly-ANNUAL � <br /> ,�� � d <br /> ��y emi � er ❑ <br /> Sprinkler ❑ ❑ Recreational Bum / j <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers �,� <br /> Hood Cleaning � ❑ O ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing(far Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> QFuel Tanks <br /> Q Other: <br />µ`.... '.,, . 'e��'�=S':`h,S Y."fSa"ti;�d',P�"3v�i9�":��r'F!`.:}Sw°� v : ,r.;r.�yir.ei�`.'BAs."�9?-'�'.rt .��' '€-!R, =�M'«'=°^�",�.£'�Y+��:.._'�1.`.`i]IMP . .-�'ale:"#'�i.l�'4�i�' i�.�9�;.°«A�'��R'�w�'.'1i�iT�"w'&'`�. <br /> Contractor Company <br /> Signature Registered Y/N Fee CuRent Y/N <br /> Address ' License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current 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 Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> Directions: <br /> Fill out application completely <br /> Owner 8�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:/lappraiser.pascogov.com) <br />
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