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13-14288
Zephyrhills
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2013
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13-14288
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Last modified
4/18/2014 2:41:43 PM
Creation date
4/18/2014 2:41:42 PM
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Building Department
Company Name
STAPLES
Building Department - Doc Type
Permit
Permit #
13-14288
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 /> Date Idaceived' � �1 '� Phone Contact for Permit <br /> -«� ..,� ��•� ,_ _ r. z� ,:� ,�...���� _ . <br /> Owners Name � �� p Owners Phone Number � � � <br /> Owner's Address G�C �t � <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> .�,;s� ,aw _ . <br /> Job Address Lot# � <br /> Sub Division Parcel# <br /> ��� <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct a Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlied Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation � <br /> Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL �� <br /> �y emi �n er � )�/ <br /> Sprinkler � � O ❑ � � Recreational Bum ,. (�1/ <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System installations <br /> Hood Suppression � ❑ O ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Toroh Roofing/Tar 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 /> %�,���,�.,:: <br /> Contractor Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current 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 IFee Current Y/N <br /> Address License# � <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# �- <br /> r�., �,,.x.�.� � � .��F�.�r x.�,�. <br /> Directions: <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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