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13-14750
Zephyrhills
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2013
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13-14750
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Last modified
7/28/2014 9:10:01 AM
Creation date
7/28/2014 9:10:01 AM
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Building Department
Company Name
EARTHWAY WELLNESS
Building Department - Doc Type
Permit
Permit #
13-14750
Building Department - Name
GRINDLE,FREDERICK
Address
5718 6TH ST
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813-780-0020 City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> ate RECeived Phone Contact for Pertnit � C� � <br /> wners Name Owners Phone Number C� �� � <br /> wner's Address J�� <br /> �e Simple Titleholder Name TiUeholder Phone Number � �� � <br /> se Simple Titleholder Address <br /> >b Address �7/ �' � �J - � <br /> Lot# <br /> �b Division Parcel# <br /> � BiaHazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood InstallaUon <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation � i� % +� I� <br /> aJ ( <br /> Emergency Generator>30 kw �LP/Natural Gas-ANNUAL Sale _ <br /> � Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL T � ^ ���� <br /> �y emi � r /I�� CO <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum h/ '` <br /> Fire Alartn � ❑ ❑ ❑ Sparfclers �- / I <br /> � � <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Install ' s <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alartn 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 /> 0 � <br /> mtractor � �' Company � <br /> gnature �/ Registered Y/N Fee Curren Y/N <br /> Address License# <br /> _ECTRICIAN Company <br /> gnature � Registared Y/N Fee Current Y/N <br /> Address License# <br /> .UMBER Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address License# <br /> =CHANICA Company <br /> �nature Registered Y/N Fee Current Y/N <br /> Address License# <br /> fHER Company <br /> �nature Registered Y/N Fee Current Y/N <br /> Address License# <br /> rections: <br /> Fill out applicaGon completely. <br /> Owner&Contrector sign back of application,notarized(Or,copy of signed contrect with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over E5000) <br /> Supply two(2)sets of drawings with appiicable dxumentation <br /> Ailow 10-14 days for review after submittal date. Paricel#-obtained from Property Tax Notice(http:l/appraiser.pascogov.com) <br />
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