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<br />City of Zephyrhills FI~'J~2~ <br />Permit Application <br />Date ReceIved - - --] ^' ~ 'J-Q ... 0 CO I -- Phori; ContKt b PennIt 1 <br /> <br />=::.l~h~~~- ~!'fi'~~7;~~. <br /> <br />F__~Nomo r---- _J -......- I <br />Fee Simple iItIehoIder Addr8a . <br /> <br />I~~ ~d/ ~v:e., ~1'~:r"fn::" <br />o <br />o <br />o <br />D <br />D <br />D <br />D RecnIaIIof_ 81m <br />D <br />D <br />D <br />D <br />D <br />~ <br /> <br />813-780-0020 <br /> <br />Job AddresS <br /> <br />Sub DivisIon <br /> <br />BIo-Huard Waste Storage - ANNUAL <br /> <br />Convn Exhaust KItchen HoodIDuct <br /> <br />C0ntr0lIed Bum <br /> <br />o <br />o <br />o <br />o Emergency Generator < 30 Jew <br />o EmergenCy Generator> 30 Jew <br />~ Protec:tIon MaInleMnC8 - ANNUAL <br />. ~~~~ <br />Sprtnlder 0 0 0 0 L-J <br />AnI Alarm 0 0 0 0 [:=J <br />Hood Cleaning 0 0 0 0 [:=J <br />Hood Suppression .181 0 0 Xf=J <br />Fire AJann Instalatlon <br /> <br />~ <br /> <br />o <br /> <br />FirePurnps <br />FireWorks <br />Flammable AppIIca1Ion- ANNUAL <br /> <br />Fuel Tanks <br />Other: <br /> <br />Contractor <br />Signature <br /> <br />Address <br /> <br /> <br />ELECTRICIA <br />Signature <br /> <br />Address I <br /> <br />PLUMBER I <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature <br /> <br />Address I <br /> <br />OTHER I <br />Signature <br /> <br />Address I <br />Directions: <br /> <br />(1//61/-1 <br /> <br />Fax-813-78()'oo21 <br /> <br />~ i'l <br />*~5~ <br />II I <br /> <br />i <br /> <br />I <br /> <br />~.l <br /> <br />I Lot# <br /> <br />-I <br /> <br />FumIg8IIon Tent . <br />Hazardous MatertaI (TIer II or RQ Facility) ANNUAL <br />Hood Insldatlon <br />LPJNatanI Gas-InstdatIon <br />LPINatlnI Gaa-ANNUAL s.Ie <br />PIIIces d AsMmbIy-ANNUAL <br /> <br />Sperlders <br />Sprinkler System JnsbIIIaIIona <br />Standpipes (Sprinkler Sys) <br />Torch RooftngITar K8tIIe <br />Waste TIre S1Drage ANNUAL <br /> <br />I Valuation of Project <br /> <br />Company <br />RegIstered <br /> <br />~/ucense # <br />rz~ Company <br />Registered <br /> <br />Ucense # <br /> <br /> <br />Company <br />Registered <br /> <br />Ucense # <br /> <br />Y/N I FeeCurrent I Y/N I <br />I <br /> <br />Company <br />Registered <br /> <br />Ucense # <br /> <br />Y/N I FeeCurrent I Y/N I <br />I <br /> <br />Y/N'I FeeCurrent I Y/N I <br />J <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Fill out application completely. <br />Owner & Contractor sign back of application. notarized (Or. copy of signed contract with owner) <br />If over 52500. a Notice of Commencement Ia required (MecMnlcal wortc over 55000) <br />Supply two {2} sets of drawings with appliCllble documentation <br />Allow 10-14 days for review after submittal d.... Parcel # - obtained from Property Tax NolIce (htlp:l/appraiser.pacogov.com) <br />