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12-13181
Zephyrhills
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Building Department
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Permits
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2012
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12-13181
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Last modified
4/16/2013 8:56:13 AM
Creation date
4/16/2013 8:56:13 AM
Metadata
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Building Department
Company Name
PRIMERICA GROUP ONE
Building Department - Doc Type
Permit
Permit #
12-13181
Building Department - Name
PRIMERICA GROUP ONE
Address
7910 GALL BLVD
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ai�-�so-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> ate Received �����2 Phone Contact for Permit �� ��� <br /> f ��� FO.1." ' ���� <br /> tivner's Name ���S j�( y Owners Phone Number C� �� � <br /> tivner's Address / �Q (>.�fC-C /f L✓� ��jp/'}y�/�jZL s �'/ 3 1�s% Z <br /> ee Simple Titleholder Name Titleholder Phone Number C� � � <br /> ee Simple Titleholder Address <br /> -- �.$ s�., - ._ - r <br /> - ���.;a ,i��e�rs� .��-�a� ~ - , n <br /> �b Address � <br /> Lot# <br /> ub Division Parcel# <br /> _ -- _- +���^w�cr,e..�.v_... .:-vx....,ry�,.�...,,efx,.y,.�...�xirt-: ._ �,,,A,��^._, .<__.r , . .- . . _ - ,.._ a _a-+r:.x�'suP:iz�a.� ,*i.�3es:�,r��+�'�t^"" xa�:-e--a - ,.'s <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 /> � Emerge�cy Generator<30 kw � LP/Natural Gas-Installation <br /> Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> P ��y e❑mi � er � <br /> S rinkler Recreational Bum <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ O ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar 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 />- - ,:_-� ,.-- _ • , ..,,. _.._ . ^�r�... :-•��:wo°rfr,�� -.�r;- � _. �- , _ � , �-:�t. ,,��;: n� <br /> _ °Tr^,aey,� �„°<A;,wlt ...y�a� �.Y:,,. axr.r z.r <br /> ontractor Company L � i" y ,�f; - <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> LECTRICIAN Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> LUMBER <br /> Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> IECHANICAL Company • <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> THER Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> irections: <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 applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http.//appraiser.pascogov.com) <br />
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