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813-760-0020 ,,At. 17r City of Zephyrhills Fire Fax 813.780-0021 <br /> f� f Permit Application <br /> Date Received - Mar Phone Contact for Permit 1 81 71 i <br /> Owners Name Florida aS rOlall ono��(assoc. Owner%phone Number $13 <br /> Owner's Address 37908 Dau a oa <br /> Fee Simple Titleholder Name Titleholder Phone Number C� <br /> Fee Simple Titleholder Address <br /> Job Address 37908 Dadghteiy Road Lot#k <br /> Sub alvislon Parcel# I t? 3 -A G,-.11 -o;,t-)o-oawo-ao zo <br /> 0 Bio-Hazard Waste Storage-ANNUAL Q Fumigation Tent <br /> 0 Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier It or RO Facility)ANNUAL <br /> Controlled Burn Hood Installation J,� ! �� <br /> R <br /> Emergency Generator K 30 kw LP/Natural Gas-Installatior Emergency Generator'}30 kw LP/Natural Gas-ANNUAL Sale <br /> Fie Protection Maintenance-ANNUAL Places of Assembly-ANNU <br /> Sprinkler ® ❑i ® or Recreational Bum f 4 �� <br /> Fire Sparklers " <br /> Hood Cleaning ❑ ❑ ❑ Sprinkler System Instatlatio ?/� <br /> ssron ❑ ❑ ❑ t� F Standpipas(Sprinkler Sys) r <br /> :retsmt Installation Q Torch Roofing/Tar Kettle <br /> Waste Tire Storage ANNUAL <br /> RFlammable Application-ANNUAL Valuation of ro)ect <br /> Fuel Tanks <br /> [� Other: I Ce t3 n/z- c 2J CY!L7LE=F7,,0_, <br /> Contractor Company _ <br /> Signature Registered ,- Y/N fee Current i Y/N <br /> Address License# <br /> ELECTRICIAN Company c9 <br /> + <br /> Signature Lk'�/ Registered r F current YIN <br /> r� <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered I Y/N Fee current L (IN <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee current <br /> Address License# <br /> OTHER Company <br /> Signature Registered FY=1 N Fee Current Y/N <br /> Address License# <br /> ��— �. _ � "_.-. .,......--_.,.._.ems..-+.__.._.....v.�..-. �s..._.-...,..,....v_-..R....... '-....-4,..-e_.....� <br /> Directions: <br /> FBI 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$50001, <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:t/appralser pascogov com) <br />