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12-13381
Zephyrhills
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Building Department
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Permits
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2012
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12-13381
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Last modified
7/2/2013 10:53:04 AM
Creation date
7/2/2013 10:53:04 AM
Metadata
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Building Department
Company Name
WELLESLEY DEVELOPMENT CORP
Building Department - Doc Type
Permit
Permit #
12-13381
Building Department - Name
WELLESLEY DEVELOPMENT CORP
Address
5518 GALL BLVD
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R", aso-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> �ate Received Phone Contact for Pertnit ��3 ,,,,�`��} ���$�� <br /> Mmers Name L� gZ-�-� �T�V�T� Owner's Phone Number �3 ..S�S 93� <br /> Mmers Address �- �• �� 1730 �j'QJ�/� ��- 3-3 6 7� <br /> ee Simple Titleholder Name Titleholder Phone Number � � �� <br /> ee Simple Titleholder Address <br /> ob Address �V�L/�,//�/ ? ��/p (�?7(,�L �L V LJ Lot# � <br /> ub Division Paroel# <br /> � BiaHazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier 11 or RQ Facilify)ANNUAL <br /> � Controiled Bum � Hood Instaltation <br /> � Emergency Generator<30 kw � LPlNaturai Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL � <br /> � emi �n er i <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum � �� � <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers ` �' ' <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ � ❑ � a Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofinglfar 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 /> :ontractor Company (i/J1//l0 �Q, <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 Company <br /> ;ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> �ECHANICA 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 8 Contractor sign back of application,notarized(Or,wpy 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:l/appraiser.pascogov.com) <br />
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