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13-13964
Zephyrhills
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2013
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13-13964
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Last modified
2/3/2014 1:56:42 PM
Creation date
2/3/2014 1:56:41 PM
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Building Department
Company Name
EMERALD POINTE
Building Department - Doc Type
Permit
Permit #
13-13964
Building Department - Name
MCKISSIC,ALLEN
Address
39602 AMETHYST WAY
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813-780-002D <br /> City of Zephyrhilis Fire <br /> Permit App►ication Fax-813-780-002� <br /> Date Received � <br /> - _..- .._. —s-:: . <br /> - -,° Phone Con <br /> - �` ' „- - = tact for Permit <br /> - ��� 9yz �943 <br /> -- -;,:._:=- -. :.: _ <br /> ,- - � _._ _r_:�__ ._F._.. <br /> owners Name �. G �� , �v �-� -- : ..� .. __;..___:..,..,. ,.W,:.= <br /> / ��/LK Owner's Phone Number ` ��°� (y <br /> Owner's Address Q� �m���Sr 0 �d 7 pgo <br /> C ��t y �/���s �L �3,�4�b <br /> Fee S�mpiP T�ttehoider Name � <br /> F�e S�mple Titlehoider Address TiUeholder Phone Number � � � <br /> -- _;._:�:-,r:.._.�;.;:a,:r_:...._.._.._ .. <br /> d,,:_::_,��._�_.:. .._-__ _. <br /> ----_ _:,.._, _. <br /> - - {-Y-:,::..,;--,_;:_.:.....__ ..__.._,.w <br /> .....-�.�=.,w...__:_.,..-_sr_.:.x�;;°_::_?-'-:: <br /> Job Address � b x ,. - "°�`�`_= - _ _ <br /> /�"�'1�rff s�.s T�,q-�i Z f�GC�s � �3.5 y-f� <br /> Sub Divisron Lot# � <br /> Parcel# ����� <br /> ❑ __ _. _ . _ .�_._:, I <br /> Bio-Ha2ard Waste Storage-ANNUAL � �t" �' -i �f�� i <br /> � Nazardous Material(Tier II or RQ Facility)ANNUAL <br /> Comm Exhaust Kitchen Hood/Duct Q <br /> � Controlled gurn Hood Installation <br /> � Emergency Generator�30 kw C� �P�Naturai Gas-Instailation <br /> � Emergency Generator> � �P�Naturdl Gas-ANNUAL Sale <br /> � 30 k�w � <br /> Fire''rotection Maintenance-qNNUAL P�a�s of Hssembly-qNNUAL �,/ <br /> � em� � a Recreational Bum '` <br /> er <br /> Sprinkier � � � � ❑ <br /> Fire Alarm ❑ � Sparklers �� ' �� <br /> ❑ ❑ ❑ ❑ jl <br /> Hood Cleaning ❑ � Sprinkler System Instaliations ' <br /> ❑ ❑ � ❑ <br /> Hood Suppression ❑ � Standpipeg(Sprinkler Sys) _. <br /> � � � � � Torch Roofin <br /> Ffre Atarm Insta�iation 9/1�ar Kettle <br /> ❑ Fire Pumps � waste Tire Storage ANNUAL <br /> � Fire Works <br /> � FlammableAppircation-,qNNUAL <br /> � Fuel Tanks Valuation�f rroject <br /> ❑ Other <br /> ContraCtor "_'�----..--. -°.-_ -_.�,_. ,.---.�._:_--- -- -- <br /> S�ynature � _— ---_� Com :r3r_,_;��:��sr.-_.=..-.: ._.�_, . ._.__._ : __ - <br /> pany T � _ <br /> Aaaress 353 f {�1 Registered Y/I� Fee Current <br /> on Y!N <br /> rLECTRICIAN LiCense# q � '� <br /> S�gnature Company z <br /> Address � ----�� Registered Y/N Fee Current <br /> Y/N <br /> nLUMBER License� <br /> S�gnature � Company <br /> Address Registered Y/�y Fee Current <br /> Y/N <br /> MECHANICAL LiCenSe# <br /> Sgnar�re <br /> Company <br /> Aadress Registered Y/N Fee Current <br />�iHE� � Y/N <br /> i ��cense# <br />��9rac��re � � Company <br /> Address Registered Y/N Fee Current <br /> -~ Y/N <br />:���E����r,� _ . <br /> � ""`` License# <br /> ,_,.. , . : <br /> _ _ <br /> -- -' .R..,_..:..:, <br /> Fi11 out appliCahon compietely - . -_�,_:_._:�_,_-,,. -- _ . <br /> Owner 8 Contractor sign back of appiication,r�ty�iZ� Or,rA <br /> If over gz500,a Notice of Commencerr�ent is required(Mechanical work over$5000) '��wner) <br /> Supply two(2)sets of drawings with appUcyble documentaUOn <br /> Alfow 10-14 days for review affer submittai date. <br /> Parcel#-obtained from Property Tax Notice(http;//appraiser.pas�9ov.com) <br />
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