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12-13677
Zephyrhills
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Building Department
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Permits
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2012
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12-13677
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Last modified
8/22/2013 11:52:25 AM
Creation date
8/22/2013 11:52:24 AM
Metadata
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Building Department
Company Name
PRIMERICA GROUP ONE
Building Department - Doc Type
Permit
Permit #
12-13677
Building Department - Name
PRIMERICA GROUP ONE
Address
7910 GALL BLVD
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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> �ate Received� – � - 2 Phone Contact for Permit � � (--� <br /> �_,._� <br /> nnmers Name � L � S ��� Owners Phone Number �� �� �-1 <br /> �J <br /> hnrner's Address �� ��L L ,(S L t/ Z ��l{r�� /�,iC�,� � �s S`�/� <br /> ee Simple Titleholder Name Titleholder Phone Number C� � C� <br /> ee Simple Titleholder Address <br /> ob Address �� <br /> Lot# <br /> ub Division Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Faciliry)ANNUAL <br /> � Controlled Bum Hood InstallaUon <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL a Places of Assembly-ANNUAL �/��� 7� <br /> ��y emi � er � / <br /> ( <br /> Sprinkler ❑ ❑ Recreationai Bum <br /> Fire Alarm � ❑ ❑ ❑ � � gp��lers <br /> Hood Cleaning � p ❑ ❑ � � Sprinkler System instaliations <br /> Hood Suppression � ❑ ❑ p � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Toroh 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 /> :ontrector Company <br /> ,ignature Registered Y/N Fee Cunent Y/N <br /> Address License# <br /> iLECTRICIAN Company <br /> ,ignature I Registered Y/N Fee Current Y/N <br /> Address License# <br /> 'LUMBER <br /> Company <br /> �ignature Registered Y/N Fee Curtent Y/N <br /> Address License# <br /> �ECHANICAL Company <br /> �ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> �THER Company �/�(,L <br /> �ignature - Registered Y/N Fae 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:/lappraiser.pascogov.com) <br />
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