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<br />APR/09/2007/MON 02: 15 PM <br /> <br />ZEPHYRHILLS BUILDING <br /> <br />FAX No, 813-780-0021 <br /> <br />-lf1~~ <br /> <br />.:3I1c <br /> <br />813-780-0020 <br /> <br />City ofZephyrhills':FIr:ei;" ':'.: <br />Permit Application <br /> <br />.:,~ 'Phor!e Contactfor Pennlt <br /> <br />Date Received <br /> <br />;ttt ~ <br /> <br /> <br />:I 813 n <br /> <br />Owner's NiUllB :1 S u/1;'1::T ~ It! S (,( "GJW>>~ It" !1:J'.J. I Owne~s Phone Number <br />Owner's AddtMS ':r73 25 C;4GA..- ,,(..(//) l..t:/PHy,(2I#'A,~' R J)S'II <br />Fee Simple TItleholder Name t I Tdleholder. Phone Nwnber <br />l=e6 Slmple'Tltleholder.Address '1 <br /> <br />"11 tJ y-, r -.. <br />I <br />., <br />,I <br />.1 <br /> <br />Job Address <br /> <br />7'J1.f CA (,( 1)(..(/1) <br />J <br /> <br />~tf?'y:J /lYI2.UU.,'..r ,::. c:: 3 ~.r~ / <br /> <br />I <br /> <br />Lot.# <br /> <br />~u <br />'1 <br /> <br />SubDivision <br /> <br />lya <br /> <br />n <br /> <br />'.L <br /> <br />n <br /> <br />- <br /> <br />o <br />D <br />'D <br />D <br />.D <br />D <br />(.omp"ej}:'t) JI $/0 t <br /> <br />o <br />D <br />',D <br />o <br />D <br />D <br /> <br />D Recreational Bum <br />o 'Sparklel'& <br />R Sprinlcler "System Installations <br /> <br />D <br />o <br />, <br /> <br />Fwnig~lion Tent <br />Hazardous Materi~1 (TIer II or RQ Faclllty) ANNUAL <br />Hood Installation <br />LPlNattJral Gas-Installation <br />L~NawraIGa~ANNUAL~ <br />. I'laces of Assembly-ANNUAl. <br /> <br />Standpipes (Sprinkl8l' Sys) <br /> <br />Torch Ro01IngfTar Kettle <br />Wa$te Tire Storage ANNUAL <br /> <br />., Valuation of Project <br /> <br />IIIIIIIIL <br /> <br />. .. Address 11J'I3 <br /> <br />ELECTRlCIANI <br />Signature . <br /> <br />Address I <br /> <br />PLUMBER I <br />Signature <br /> <br />Address I <br /> <br />MeCHANlCALj <br />Signature . <br /> <br />Addresl'l I <br /> <br />OTHER I <br />Signatu.... . <br /> <br />AddrB&l> rl <br />Dlrectloml: <br /> <br />., <br /> <br />~n-r; pc.. ~~Zotl' <br /> <br />I <br />, <br />I <br />-, <br />I <br />I <br />J <br />I <br /> <br />r <br />Company I FI~ G8l/.;f}tJl>c.. $vsJaln..s ~ "~I <br />Reglstel8d ~ N 1 Fee Current I Y I N 1 <br /> <br />Licen~_#_...l 13IYJ't::Jo ~Q /2 .O~ <br /> <br />~~:~ I <br /> <br />L1cel1ge ~ I <br /> <br />Company I <br />Registered . Y I N <br /> <br />License # I <br /> <br />Company I <br />Registered Y I N I. Fee CUlfent I Y I N <br /> <br />. Ucel1ge # I <br /> <br />:;:':d 1- Y I N I. Fee Currant <br />Licene # L <br /> <br />J <br /> <br />Y/N l FltBCUrranl I Y/N I <br />I <br /> <br />L Y7N I <br />I <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Fill out appllca1ion complelsly. <br />Owner & ContraelOr sign bac:k of application. notBrizsd (Or. copy of signed contnl<:l with owner) <br />If over $2500, a Nottce of Commencement ilirequ/red.(Mechanlcel work over $5000) . <br />Supply two (2) Bsb; of drawings with applicable dooumentation . . <br />Allow 10-14 days for review after submittal dais. Parcel #. obtained flOn'! Property Tax Notice (http://appralser.pascogov.com) <br />