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13-14052
Zephyrhills
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2013
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13-14052
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Last modified
3/24/2014 12:03:35 PM
Creation date
3/24/2014 12:03:34 PM
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
13-14052
Building Department - Name
CHRISTOPHER & MADISON CORP
Address
5327 GALL BLVD
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813-780-002D City of Zephyrhilis Fire Fax-913-780-0021 <br /> Permit Application <br /> �ate Received �� Phone Contact for Permit [� � 2- L <br /> �wner's Name !�.[--�� Owners Phone Number � 3ZZ �j � <br /> ►wners Address �J� U"�"� [7� <br /> ee Simple TiUeholder Name Titleholder Phone Number � � � <br /> ee Simple Tideholder Address <br /> ob Address �J v� l � � (J � Lot# � <br /> ub Division Paroel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> aControlled Bum Hood Installation <br /> Emergency Generator<30 kw LP/Natural Gas-Installation /] ?j <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale ,��j �V� <br /> � Fire Protection Maintenance-ANNUAL a Places of Assembly-ANNUAL <br /> � emi � er � <br /> Sprinkler � O ❑ ❑ � Recreational Bum �� <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers J�/ � �� " <br /> W � <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations �� ^� <br /> Hood Suppression � � ❑ ❑ � � 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 �f�, � Company p �� '�� <br /> �ignature � / Registered Y/N Fee Current Y/N <br /> Address License# <br /> :LECTRICIAN ,�� Company <br /> ,ignature I Registered Y/N Fee Current Y/N <br /> Address License# <br /> 'LUMBER Company <br /> ,ignature Registered Y/N Fee CumeM Y/N <br /> Address License# <br /> �ECHANICA Company <br /> ,ignatu�e 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 ConVactor 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:!/appraiser.pascogov.com) <br />
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