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13-14742
Zephyrhills
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2013
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13-14742
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Last modified
7/28/2014 9:03:00 AM
Creation date
7/28/2014 9:02:59 AM
Metadata
Fields
Template:
Building Department
Company Name
PEDIATRIC PARTNERS
Building Department - Doc Type
Permit
Permit #
13-14742
Building Department - Name
LUSARE INVESTMENT HOLDINGS LLC
Address
6712 DAIRY RD
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873-780-0020 City of Zephyrhills Fire Fax-s�saso-ooz� <br /> • Permit Application <br /> atc R_-_2�ved <br /> A . . ',s..._.�_...._- �.s�.. •a��._: �� <br /> Phone Con�ct tor Pertnit 9�I 2 �9 9 <br /> :_:��._.::._...:�.:- ...___. __3 � .�:,..-.:=.•.�.,,�-,.;,r___._� _.. _ _ <br /> — ...Q�.x*�� -'�s��.,-_._.�.. - .. . _._. <br /> _....__�_�..:� <br /> _.��_-_.-..�.._- �.��:.x�-_.,:,h�:=..�...._._;:.R.._ .�z:-�- _..��..__ _.._. <br /> �',wn�r's Name �/"i�/!�-Til�./G /�'.�.�/J�� Owner$PhOr1e Nurttbe' d f� ��� G70�`l <br /> ��-�z,�Addfeu G��/.� t�r�/�zY k�i� ,z��e��S �G 3 35'�.z ; <br /> �ee S�m�ie Titlehoider Name TiqeholdBr Phone Number �� �� ^I <br /> S�mpie��uenoiuer qadress �i <br /> -_�:.:"�'�•;.:?:'"�T��:�c�-.z=xi#saee��.+�..i._ ,.-�,�,..=�r_—.�...�-",- .`-.—=u_��....... '--� <br /> - ��n.■��rr��ov3irrc-- -`"_+i�;;�:_�_;_. ,_ <br /> ;;;h Address �G'T/� � /� � ��l�'!'�If/LLS �L ���5��' �� <br /> Lot# <br /> Suo Div�sion ��� <br /> _:..,----.._., �...._.,c;,,,— ,_..._-�,�.__ ._„_,_.: � i <br /> -"-"----_' �"�5��^i24�x;:�r�,��fx:3€�;ti�-�ea�,.�� - — - - ��__ _ . <br /> _ _ �..., �.»d_.g..�__ —�1R—'�—_��.:.,....� ..,��:..�_x =_-- <br /> � BiaHazard Waste Storage-ANNUAI. � Iiaza��a(�Aaterig��er II or RQ Facility)ANNUAL � <br /> � Comm Exhaust Kitchen HoodlDuct o ������ <br /> � Controlted Bum ... � lP/NaturB!Gas-lnsia(iation <br /> � Emergency Generator�3a kw � Lp/Nafura�GayqMN()AL Saie <br /> � rmergenc.y Generator�3U'scw � "riao.;s a Asssm�ly-/1t�iNii�►C <br /> oFire Protection MaiMenance.ANNUAL � ��tetbnsl Bum <br /> o� �,�� ❑ <br /> Sprinkler Q t7 p SperWers <br /> Fire Alarm � ❑ Q � � a �nkler System Insiallations <br /> Hood Cleaning ❑ i7 O � S�n�p�p�{Sprinkler Sys) <br /> Hoa Supptession O [7 t"J � Tordt RppfingtTar Ketpe <br /> � Fire Alarm Installation a yy�j�'r'��p��qNNUAL <br /> � Fire Pumps <br /> Fire Works <br /> � Flammable ApplicaGon-ANNUAL �••••��••�.... <br /> QValuation of Project <br /> Fuel Tanks <br /> [] Other: <br /> -._. - ---_"':��, g —� <br /> Ccn;ractor R�==����_:-_..- <br /> ��gnaiure �Y � ( �•O <br /> Rt9��d Y N Fee Cwrent Y/iV <br /> Address 3 rj � �e n` � <br /> �# �£FOOOOy�-t! <br /> :=I_�CTRICIAN <br /> ,iynature COmpafly <br /> R�9��ed Y 1 N Fee Current Y/N <br /> Address � � <br /> lJC@r�sC# <br /> rLJbiBclt <br /> S,gn,3tu�e � � CO(YiPef►Y ..____a.._..._.__.___.___ ---- <br /> � Repistered Y/N Fee Current Y/N <br /> ��darFSs <br /> '.iPt,HtiN1LAL ��Se# � <br /> pn;,ture Company <br /> RegislereC Y_/N Fee Currant Y/N <br /> Aoare;s <br /> Tr''-F� �� � � <br /> i�IJI�fa � —! <br /> Re9iste�ed Y!N Fee Current Y/N� <br /> Address <br /> - _ ._:__:;:�._..��-�,.s---= <br /> --- - :_ -- <br /> �- ,:ui, �°`•'--�=�°' - <br /> 5 - .:,_T.....=�.__.�..,_r_v:._ �;-:_-..6� - <br /> F�N ouY aDP�+ca�tion compleFely °--- - � �..� _-- -- - - <br /> Owner 8 ConVac[or sign badc of applica0on,notarized(Or,�PY uf signed contract with avnerj <br /> ff over 52500,a Notice of Comrhenpertsent is required(M�n�ai wor��yer SSOOty) <br /> SuPpIY two(2)sets ot draw9nps wttllBppNCap�g poauslentation <br /> Ailow 10-74 days for reyie�nr aRer sUprrdt�l t� <br /> Ratoel�-obtainetl ifam Ptoperty T8x Nobce(http://appraiser.pascpgov.com) <br />
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