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13-14110
Zephyrhills
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13-14110
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Last modified
3/25/2014 8:42:31 AM
Creation date
3/25/2014 8:42:30 AM
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Building Department
Company Name
ZEPHYRHILLS CINEMA 10
Building Department - Doc Type
Permit
Permit #
13-14110
Building Department - Name
ZEPHYRHILLS CINEMA 10
Address
6848 GALL BLVD
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ais-�8o-002o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received " �� ��d <br /> ,�,.��,ry Phone Contact for Permit <br /> , „�.��.��.,m�.r:.,.;�. :..� . _.. . : � „ �-:,-�.���.�-_> . <br /> Owners Name �,�/ Ovmers Phone Number o� (�� Q�O'� <br /> Ovmer's Address (r} � �' � A <br /> Fee Simple Titleholder Name Titleholder Phone Number � � C� <br /> Fee Simple Titleholder Address <br /> �°*� , ��at�' <br /> Job Address /y� �/ A �76 � Lot# � <br /> Sub Division Parcel# <br /> �._ <br /> a Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct a Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> a Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL a Places of Assembly-ANNUAL <br /> � em� � er <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum (� � <br /> l � � <br /> Fire Alarm � ❑ ❑ 0^� � Sparlclers � <br /> Hood Cleaning � ❑ ❑ O � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) � �� ( ���C' <br /> � Fire Alarm Installation a Torch Roofing/Tar Kettle � <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> aFire Works <br /> � FlammableApplication-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> ���.:���.:�,;. <br /> Contractor Company <br /> Signature Registered N Fee Current Y/N <br /> Address /C w /4 I,� j� License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Curtent Y/N <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <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 /> _ x� n:.�� <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://appraiser.pascogov.com) <br />
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