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12-13004
Zephyrhills
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2012
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12-13004
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Last modified
2/14/2013 10:31:19 AM
Creation date
2/14/2013 10:31:19 AM
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Building Department
Company Name
CITY OF ZEPHYRHILLS
Building Department - Doc Type
Permit
Permit #
12-13004
Building Department - Name
CITY OF ZEPHYRHILLS
Address
5028 AIRPORT RD
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81378D-0020 City of.Zephyrhills�Fir•.e� FaX-a�s-�ao-oozi <br /> . Permit Application <br /> Date Received y �'� � Phone Contact for Pertnit 7 <br /> Owners Name �' Owners Phone Number -�� �-� <br /> Owner's Address �► � <br /> Fee Simple Titleholder Name TiUeholder Phone Number C� � � <br /> Fee SimpleTitleholderAddress <br /> Job Address �J�.b�� l� r'," ��i s F ► 3��a Lot# � <br /> 5ub Division <br /> Paroel# <br /> � Bio-HazarcJ Waste 5torege-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood tnstallatlon <br /> � Emergency Generetor<30 kw � LPMatural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Naturel Gas-ANNUAL Sale <br /> � Fire Protection Mairrtenance-ANNUAL � Places of Assembly-ANNUAL <br /> ❑� emi � er <br /> 5prinkler O 0 � Recreational Bum � / �� <br /> �� � / <br /> Fire Alarm ❑ p � Sparklers 1 <br /> Hood Cieaning p ❑ ❑ Sprinkler System Installations <br /> � Stand i s S rinkler S <br /> Hood Suppression � O ❑ ❑ �� � P� � P �� <br /> � Fire Alartn Installation � Toroh RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application-ANNUAL �—_—� Valuation of Project <br /> Fuel Tanks <br /> � Othe � <br /> Contractor Company I <br /> Signature Registered Y/N Fee Current /N ��a, <br /> AddFess License# <br /> ELECTRICIAN Company <br /> 5ignature " 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&Contractor sign back of application,notarized(Or,copy of signed conVact with owner) <br /> tf over 52500,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 reviaw afier submittal date. Parcel#-obtained from Property Tax Notice(httpJ/appreiser.pascogov.com) <br />
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