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<br />813,780-0020
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<br />Date Received
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<br />Owner's Name
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<br />, , Job Address,
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<br />Sub Division
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<br />Contractor
<br />Signature
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<br />Address L"
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<br />ELECTRICIANI
<br />Signature
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<br />AddreSs I
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<br />ZEPHYRHILLS BUILDING
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<br />FAX No. 813-780-0 ~,
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<br />City OfZ~phyrhills Fire
<br />'Permit f'pplication
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<br />. Phone Contact for Permit,
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<br />")I ,_.h_ ,r I T -
<br />BiD-Hazard Waste Storage - ANNUAL. '
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<br />Comm Exhaust Kitchen Hood/Duct.
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<br />Controlled Bum
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<br />Emergency Generator <: 30.kw
<br />Emergency Genel<ltor > 30 kw
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<br />Fire Alarm
<br />Hood Clean/SuppressIo'
<br />Fire Alarm Installation
<br />Fire Pumps
<br />Fire Works
<br />Flammable Appllcatton. ANNUAL,
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<br />Fuel Tanks
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<br />Other:
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<br />LUp('(l\nn\-'~ ~'. (y) ,l Ll' i
<br />Owner's Address I~~~() E \\~lp\\~~[flLU Y ; ",. ,"... ,
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<br />Fee ~mple "'ohold" N,me ' I ~" ' ',' DTIIl"""'~ PhoM N~
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<br />Fee Slmple Titleholcler AddreSS I. .'.. .
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<br />PLUMBER
<br />Signature
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<br />Address I
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<br />MECHANICALl
<br />Signature I
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<br />Address I
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<br />OTHER
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<br />SJgnature
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<br />Fax.8'13C780-0021
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<br />I Owner's. Phone Numbe~
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<br />Parcel '#
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<br />o 'Hood Installation
<br />o lP/Natural Gas-InstallatIon
<br />o L.P/N&tul<lt, Gas-ANNUAL Sale,
<br />o Places of Assembly-ANNUAL.
<br />o RecrE!atlonal Bum
<br />. 0 Sparklers
<br />. 0 Sprinkler System Installations
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<br />I D Waste Tire Storage ANNUAL
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<br />n \ ml fi lr'""'<;mn i
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<br />I Lot # I I
<br />13'-t - '.;)5:-;) \C' 6000 ... ()(;~( - 00)01
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<br />(Ut; IAINt:.U I-I'<UM PK~Pl;~IY lAX. ~u II~~)
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<br />Fumigation Tent ' .' \ .
<br />Hazardous Material (Tier II or RQ F~cillJ) ANNUAL
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<br />.-tr1'3 1?
<br />11~
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<br />Standpipes (Sprinkl",r $Ys)
<br />. Torch Roofing
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<br />Company
<br />Registered
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<br />. License #
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<br />Valu,~tlon of Project
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<br />Company
<br />Registered
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<br />license #'
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<br />Company.
<br />Ragistered
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<br />Ueense -#
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<br />Company
<br />Registered
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<br />, LIcense #
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<br />Company
<br />Reqistered
<br />
<br />License #.
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<br />Fee Current
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<br />Fee Current
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<br />Y I N I
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<br />Fee Current
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<br />I Y IN I
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<br />I . Y I N I Fee Current I Y I N I
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<br />."iij OLlt application Cumple!elV,
<br />'Jwner &. Contractor 51gn toacK GT application. notariZeo {Or. :;cpy of signed contract Wltl'l owner!
<br />It o'l..r $2500, <l Notice of Commencement iQ rsquired (Mecnanipal work over S5000)
<br />SuppiY;I\'o (2) $e!s at -jrswlngo '.vrth appiicable documentation . -
<br />,-\Ilow 10-14 days for review after sUDm;ttal date.
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