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12-13429
Zephyrhills
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Building Department
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Permits
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2012
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12-13429
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Last modified
7/18/2013 10:28:28 AM
Creation date
7/18/2013 10:28:27 AM
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Building Department
Company Name
WELLESLEY DEVELOPMENT CORP
Building Department - Doc Type
Permit
Permit #
12-13429
Building Department - Name
WELLESLEY DEVELOPMENT CORP
Address
5518 GALL BLVD
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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> ate Received �-� Phone Contact for Permit � � � <br /> -- - o� yS D 3 <br /> yvner's Name Owners Phone Number <br />�vners Address ���� �� �� <br /> ae Simple Titleholder Name TiUeholder Phone Number � � � <br /> ae Simple Titleholder Address <br /> �b Address <br /> Lot# � <br /> �b Division Parcel# <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 InstallaUon <br /> � Emergency Generator<30 kw � LPlNatural Gas-Installation <br /> � Emergency Generator>30 kw LPlNatural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL <br /> �y emi � er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum <br /> Fire Alartn � ❑ ❑ � � � Sparklers <br /> Hood Cleaning � ❑ O ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Atarm 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 /> Q Other: <br /> mtractor ���r� �n f J � ,�,� Company <br /> gnature � ��«�'�r` Registered Y/N Fee Current Y/N <br /> Address License# <br /> .ECTRICIAN Company <br /> �nature � Registered Y/N Fee Current Y/N <br /> Address License# <br /> .UMBER Company <br /> 3nature Registered Y/N Fee Cument Y/N <br /> Address License# <br /> =CHANICA Company <br /> 3nature Registered Y/N Fee Current Y/N <br /> Address License# <br /> fHER Company <br /> 3nature Registered Y/N Fee Current Y/N <br /> Address License# <br /> rectlons: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized(Or,copy of signed contrect 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 Ta�c NoUce(http:/lappraiser.pascogov.com) <br />
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