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12-13617
Zephyrhills
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Building Department
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Permits
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2012
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12-13617
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Last modified
8/22/2013 11:10:29 AM
Creation date
8/22/2013 11:03:10 AM
Metadata
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Building Department
Company Name
ZEPHYR HAVEN NURSING HOME/S C NURSING HOMES OF ZEPHYRHILLS
Building Department - Doc Type
Permit
Permit #
12-13617
Building Department - Name
ZEPHYR HAVEN NURSING HOME/S C NURSING HOMES OF ZEP
Address
38250 A AVE
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a�3-�so-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application . <br /> Date Received � � �� Phone Contact for Permit I!ZL.� (�s'� B�3' <br /> Owner's Name � �� (/''/ %� ' Il?'L Owner's Phone Number � � � <br /> Owner's Address � � � � <br /> Fee Simple Titleholder Name Titlehoider Phone Number C� � � <br /> Fee Simple Titleholder Address <br /> Job Address Lot# � <br /> Sub Drvision Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> a Comm Exhaust Kitchen Hood/Duct � Hazardous Matenal(Tier II or RQ Facility)ANNUAL <br /> � Controlled Burn Hood Installation � <br /> � Emergency Generator<30 kw � LP/Naturaf Gas-Installation �!A I�' <br /> o � �e <br /> Emergency Generator>30 kw a LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenarice-ANNUAL � Places of Assembly-ANNUAL <br /> y em; a.n Utner <br /> Sprinkler � �7 � � Recreational Burn <br /> Fire Alarm � ❑ ❑ � � � Sparklers <br /> Hood Cleaning � ❑ � � � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkter Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � �Naste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Appiication-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> � Other <br /> Contractor Company i� �C%r�l <br /> S:gnature Registered Y/N Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature I Registered Y/N Fee Current Y/N <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y J N Fee Current Y/N <br /> Address �_ I ❑cense# I � <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 8 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 applicabie documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:/lappraiser.pascogov com) <br />
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