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813ae0-0020 City of Zephyrhills Fre Fax-813-780-0021 <br /> Permit Application <br /> Date Received <br /> ^.., _ - Phone Contact for Permit 17Z7 11 <br /> Owners Name 61045 <br /> o Aj 6P jF .1 Owners Phone Number 3 7 �9 <br /> Owners Address <br /> Fee Simple Titleholder Name 4 A9W�L TitlaholderPhone Number <br /> Fee Simple TifleholderAddress - <br /> ,_.—��„-.,.-.4t_ <br /> 1<Y_.___.3'•.-.-.+.-,__i:s-�_:".�i�..'rr--..r+.�w S�:-..�..5'.......^..sc...:�..`x..1t_v1�-y' - '�' - " --xc a,S."t_^�;s- _..^'+^-_^�:'_`.r'4"_<..'^:sr,?r:y'_^.'-._�� <br /> Job Address 7 !�G ��� .y LG� 3�5�2 Lot# <br /> Sub Division Parcel# 200'p7— <br /> Bio-Hazard Waste Storage-ANNUAL F-1 Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct Hazardous.Material(Tier 11 or RQ Facl*)ANNUAL <br /> Controlled Bum Hood Installation <br /> Emergency Generator<30 kw LP/Natural Gas-Installatior <br /> 0 Emergency Generator>30 kw Q LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL Q Pieces of Assembly-ANNUAL <br /> ❑® emi Q o er IS <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> 44 <br /> Fire Alarm Ej ❑ ❑ ❑ Sparklers <br /> Hood Cleaning ❑ ❑ ❑ Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ Standpipes(Sprinkler Sys) <br /> Fire Alarm Installation a Torch Roofingrrar Kettle <br /> Fire Pumps o Waste Tire Storage ANNUAL <br /> HFlammable Application-ANNUAL s� = Valuation of Project <br /> Fuel Tanks <br /> [� Other. <br /> <_ <br /> Contractor F d/ O, /. Company <br /> Signature Registered Y/N Fee Current - <br /> Address A �2ig /7. L• License# <br /> ELECTRICIAN Company <br /> Signature Registered YIN Fee Current Y 7 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 IN <br /> Address. License# <br /> OTHER Company <br /> Signature Registered Y/N tree Ctrrent Y/N . <br /> Addressj License#' <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(httpJ/appraiser.pascogovcom) <br />