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<br />FEB/20/2007/TUE 11: 10 AM <br /> <br />Fef;l Simple Illlenoldf;lr Name <br /> <br />Fee SImple lIt1eholder Addrf;lss <br />lIT <br />r <br />./ <br /> <br />OTHER <br /> <br />Slgnatu~ <br /> <br />AddrEl&s L <br /> <br />OIrectlonlll: <br />Fill out application ccrnpletely. <br />Owner & Contractor $Ign beck of appllcatlon. notariZed (Or. copy of sIgned cootract with ownsr) <br />It over $2500, a Notice of Commencement Is reQuired .(Mschan~1 work over $5000) , <br />Supply two (2) se~ of drawings wIth applicable dOCUffieOtlation <br />Allow 10-14 days for review after submIttal date, <br /> <br />'813::'7SO:0020 <br /> <br />. .~; .~U; ;r~""'~ . <br />.Date R8ceived ,.. --. .. .-. <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Job Address <br /> <br />Sub 'Olvlslon <br />~~- ~ <br /> <br />o <br />D <br />D <br />D <br />..D <br />D <br /> <br />COhtractor <br />Signature <br /> <br />Addre'a I. <br /> <br />ELECTRICIANI <br />Signature <br /> <br />AddreB6 .1 <br /> <br />PLUMS~Ii: <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature <br /> <br />Add~as I <br /> <br />ZEPHYRHILLS BUILDING <br /> <br />FAX No, 813-780-0021 <br />#- 7f; f39 <br /> <br />. "'~~1'i: <br /> <br />p, 002 <br /> <br />.. <br />City ofZephyrhil/$1F;~~~. <br />Permit Application:...-. <br />..~ _:!.:'.~'! ,:"J:=' ".=: :~... __.,. ....--- <br />:.' '~~'. ~Pliorle Contactfod'C1rmlt <br /> <br />'Fax-81 ~78Q.OO21 <br /> <br />. ..:q".; <br /> <br /> <br /> <br />fI""''''l'"'a. . <br /> <br />~r's I?hone Number <br /> <br />T1t1ehCllder PhCllle Number <br /> <br />L <br /> <br />- <br /> <br />~ <br /> <br />l1lif <br />., <br /> <br />I Lot# <br /> <br />. Parcel # <br /> <br />.I ~, <br /> <br />If <br /> <br />i r <br />Bic-Hazard Waste Storage .,ANNUAL <br /> <br />Comm Exhaust Kitchen Hood/lJuct <br /> <br />o <br />o <br />D <br />D <br />. D LPINa.tunll Gas--ANNUAL Sale <br /> <br />'. 0 . Places of ~sembly.-ANNUAL <br /> <br />!#umlgation Tent <br />Hazardous Materlal (list II or RQ l='acIl1ty) .ulNUAL <br /> <br />Hood InstlaUatlon <br /> <br />LP/Netural Gas-lnstallilUon <br /> <br />Sprinkler <br />Fin;! Alarm <br /> <br />~ecrelltional.aum, . <br />Sparf<leirs <br />Sprinkler S)"tem Installations . <br />StandplpEls (Sprinkler Sys) <br />'torch R00llngITw Kettle . <br />Waste iJre Storage ANNUAL <br /> <br />Hood Clesnlng <br /> <br />Hood Suppresslon <br /> <br />D <br />~ <br />D <br />D <br />I <br /> <br />Fira Alarm Il1liItallallon <br /> <br />i=lre Pumpa <br />Fire Works <br />Flammable ApplicatIon- ANNUAL <br /> <br />J Valuation of Project <br /> <br />. Fuel Tanks <br />Other: <br /> <br />" <br /> <br />Company I <br />Regi~ered . <br /> <br />license # .I <br /> <br />Company I <br />Registered . <br /> <br />UCflnse ~ I <br /> <br />I <br /> <br />I <br /> <br />COmpany I <br />Reg!sterBd . <br /> <br />. License #. I <br /> <br />Company I <br />Registered . <br /> <br />License # l <br /> <br />-I <br /> <br />I <br /> <br />'Y I Nl <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />I Y IN I <br />I <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Fee Current I <br /> <br />Y/N <br /> <br />Y/N <br /> <br />.Y/N I Fee Currant -, =Y-/ N " <br /> I <br />Y/N ., l=ee Current I Y/N , <br />- rr- I <br /> <br />tun <br /> <br />Plln;:eI #- obtained from Property Tax Notice (http://lilppraiser.pascogov.com) <br />