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13-14710
Zephyrhills
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2013
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13-14710
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Last modified
7/28/2014 8:31:18 AM
Creation date
7/28/2014 8:31:18 AM
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Building Department
Company Name
WESTBROOK MANOR
Building Department - Doc Type
Permit
Permit #
13-14710
Building Department - Name
FLORIDA SENIOR PROPERTIES
Address
6701 DAIRY RD
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��_�,�C� <br /> 813-780-0020 City of Zephyrhilis Fire ` Fax-813-78 2� <br /> Permit App' tio r. ^ � <br /> Date Received ��, �/ h�ne Contact for Permit �/?j C.�� �� / /�1 <br /> �- '_L:_/J <br /> Owner's Name � ��s�Pho�Number C� � � <br /> ��J <br /> Owner's Address <br /> Fee Simple Titieholder Name �� (� L Titleholder Phone Number � � �� <br /> Fee Simple Titleholder Address <br /> Job Address V1�U ���, � � /' I � �� �� Lot# � <br /> Sub Division <br /> Parcel# <br /> a Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tier il or RQ Facility)ANNUAL <br /> � Comm Exhaust Kitchen HoodlDuct Q Hood Installation <br /> � Controlled Bum � LP/Natural Gas-InstaHation <br /> � Emergency Generator<30 kw a LP/Natural Gas-ANNUAL Sale <br /> � Emergency Generator>_3,0._.k-w--�' � Places ofAssembly-ANNUAL <br /> �' �� o ( � <br /> rotection Main anYerf`ce-ANNUqE Recreational Burn � �] <br /> Y er � � � <br /> Sprinkler ❑ ❑ Sparklers <br /> Fire Alarm ❑ ❑ ❑ � ❑ Sprinkler System Installations <br /> Hood Cleaning � ❑ ❑ G � � Standpipes(Sprinkier Sys) <br /> Hood Suppression � ❑ ❑ ❑ � � Torch Roofing/Tar Kettle <br /> � Fire Alarm Installation � Waste Tire Storage ANNUAL <br /> � Fire Pumps <br /> � F�re Works <br /> � Flammable Application-ANNUAL <br /> � Valuation of Project <br /> Fuel Tanks <br /> � Other• <br /> Contractor <br /> Signature L Company �� V <br /> Registered /N Fee Current /N <br /> Address /(I � Q_ a. � License# <br /> EIECTRICIAN <br /> Signature <br /> Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> PLUMBER <br /> Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> Lioense# <br /> MECHANICAL <br /> Company <br /> Signature Registered Y/N Fee Current Y J N <br /> Address <br /> License# <br /> OTHER <br /> Signature <br /> Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> Directions: <br /> Fill out application completely <br /> Owner 8 Contractor sign back of application,notarized(Or,copy of signed conVact with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) <br /> Suppiy rivo(2)sets of drawings with applicable documentation <br /> Ailow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice htt /Ja <br /> ( p: ppraiser.pascogov com) <br />
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