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12-13302
Zephyrhills
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Building Department
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Permits
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2012
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12-13302
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Last modified
6/28/2013 2:15:03 PM
Creation date
6/28/2013 2:15:03 PM
Metadata
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Template:
Building Department
Company Name
ZEPHYR HAVEN NURSING HOME
Building Department - Doc Type
Permit
Permit #
12-13302
Building Department - Name
ZEPHYR HAVEN NURSING HOME
Address
38250 A AVE
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8i3-780-9oz0 Cify of Zephyrhilts�ire Fax-813-78a002'i <br /> Permit Application <br /> Date Recefved Phone Contacl for Pertr�il <br /> ,; .. .. ,.-. ...,- ..., - -_- -- - - --_ - _- -=-- - - - _-_ -- - - - <br /> �-___.-' '__-'-.-�=-. �- _..._. ,��,._-_-..:,;.,=--r::r,...;�1._ _ -..--_- . . _r._._ �...._�.-.r_..�_._.�.�•.-•---.�__�. __.,._= _ _..—_•-.. -. <br /> _ ._ --�.� <br /> Owners Name a �. Owners Phone Number � � � <br /> Owners Address <br /> Fee Sfmple TiUeholder Name TitlahaAder Phone Number � � � <br /> Fee 3imple TiUehofder Address <br /> _ _ _ �. . _• �_ �Le'.��_�� �..�_�_+��w"`Y�.:.H ��,v_� .�s�...'�- ..-V� .1.��. ���'.�'w�-�w�a,.' <br /> c-ra=�F'-r--:J-�—.—+s--.��Te_Y'�__, r':'-��.-�i�'- +[ari�.r '"�:.w-w'..- ' �k::.ti-_T:..^:.U':"S:ui __ _ ��...�,r,`.��,.c..! <br /> k: <br /> JobAddress � Lot1� � <br /> Sub Division Parcel# <br /> .=�c- -�_���.�;y�tt:��-�,- �*ix��ai�t?��-n-;�^�.�_...-,L�_-i:�-*.:x, � r: -=r.�.. - - - <br /> �-�'.ri',���^��ae%•lt'� r��'��Y.:`s._._.. i:�'�ac�.. -'�.'�f.T-�-'ihC.�f: <br /> � B'ro-Hazard Waste Storage-ANNUAL � Fumfgadon Tent <br /> � Comm Exhausl iGtchen liood/Duct � HezaMous Meteri�(Tier 11 or}2Q Facilityj ANNUAL <br /> � Controlkd Bum � Hood installation <br /> � Emerpency Generator<30 kw � lPlNahxal Gas-Inatalletion <br /> � Emergency Generator>30 kw � lPlNaturai Gas-ANNUAL Sale <br /> QFire Protedlon Malnlenance-ANNUAL � Plaroes of Assembly-ANI�1Al. <br /> �� � � ef � /3��v <br /> Sprinkier � O O Reaeational8um ,�� <br /> Fire Al�m � ❑ D O � � Sparklers l I <br /> Hood Cleaning � ❑ ❑ d � � Sprinkler System tnstallations <br /> Hood Suppressbn � Q ❑ D � � Standpfpes(Sprinkler 5ys) <br /> � Fire Afarm instellation Q Torch Roofinglfar Keltle <br /> � Fire Pumps � Waste Tire Storage ANtJUAL <br /> QFire Works <br /> � Flemmable Applicadon-ANMUAL V01Uet10�Of PfOj2Ct <br /> � Fue[Tanks <br /> � OEher: <br /> _� - -=�- --.�...�m- =- - ----.._..,....�.==� - --- - - - - <br /> - -�- -- - -�=_-_.� ,-�_-.�__.�.,_:,--_:-.:>� .., a T.�--.—e,�-.-�.._,:..__ .:�_ .. - - : - - - .- --.-- '--- ._� ....=�� _ :�-=�--- .. ,. -;�. <br /> '__" . -.._ i'�. .-���.;+ <br /> Convactor Company <br /> Signat�xe �� Re�is►ered Y/N �ee Current Y/N <br /> Address 1f License# <br /> ELECTRiC{AiJ �flmpgny <br /> Sipnature Repistared Y 1 N Fee Current Y/1�1 <br /> Address Licenae# <br /> PLUMBER Cp���y <br /> signeture Registered Y/N Fee Current Y!N <br /> Addreas License# <br /> MECFiANICA �mp�y � - <br /> Sipnature Registered Y/N Fee Curcent Y/N <br /> Address License# <br /> OTHER �P�y <br /> Sipnature Registered Y/N Fee Current Y/N <br /> Address Licensa# � <br /> Dhectinns.-- ,: .- � -_-------,--T- ��-,.�.,�. . -. �_ ..:._, .__--=-- -.-�-...: - - •------ =.-=r.. <br />
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