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<br />~ ,,\~{j; <br /> <br />City of Zephyrhills F~Y..'2~ <br />Pennlt Application <br /> <br />813-780-0020 <br /> <br />~~ate ReceMId .c. -:--:- =1 I .~ Coract for Pennlt "I <br /> <br />::::. . -I ;;jf:/!~~'~,b:~~&;;u1 <br /> <br />Fee Simple TItleholder Name I Il1tlehoIder Phone Number I <br />Fee Simple 1ltIehoIder Add.... I <br /> <br />9#k'~ <br /> <br />Fax-813-780-0021 <br />U U <br />n 1'1 <br />II II <br /> 1 <br />I Lot. "I <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />Parcel # <br /> <br />J <br /> <br />Contr8Ctor Company <br />Signature Reglst1nd <br />Address license # <br /> Company <br />-8ly'''w,.. Registered Y/N I Fee Cunw1t I Y/N I <br />Address I license # I <br />PLUMBER I Company <br />Signature Registered Y/N I Fee Current I Y/N I <br />Address I License # I <br />MECHANICALI Company <br />Registered Y/N 1 Fee CwIWlt I Y/N I <br />Signature <br />Address I license # 1 <br />OTHER I Company <br />Signature Registered Y/N'I Fee CwIWlt I Y/N I <br />Address I l.Icerwe # I <br />Directions: <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Bio-Hazard Waste SlonIge - ANNUAL <br />Comm Exhaust KItchen HoodIDuct <br />C0ntr0lIed Bum <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Are ProtectIon MaIntenance - ANNUAL <br />.0 I!!!!lII!!!!!) ~ ~ <br />o OOL-J <br />Doooc=J <br /> <br />l:Joo ~oo~ <br />Hood Suppression ~ ..1"\ L--I <br />Ant Alarm Instaftatlon <br /> <br />SprInIder <br /> <br />Ant Alarm <br /> <br />Hood CleanIng <br />. <br /> <br /> <br />_.~... - <br /> <br />-rire P~mps <br /> <br /> <br />D FumigalIon Tent <br />D Hazardous MaIIIrIaI (TIer II or RQ Facility) ANNUAL <br />D Hood Installation <br />D LPlNatLnl Gas-lnsta1l8tion <br />D LPlNatunll ~NUAL 5111e <br />D Places of AssembIy-ANNUAL <br /> <br />D Rec:teationaI Bum <br />D Spartders <br />D SprtnIder SysI8m 1l1Stllla1lol1S <br />D St8ndpIpes (SprInkler Sys) <br />D. Ton:h RcoIIngfTarKeUle <br />D Waste Tn Storage ANNUAL <br /> <br />l Valuation of Project <br /> <br /> <br />FBI out eppblion completely. <br />Owner & c:onnctor sign blIck of application. notlIrized (Or, copy of ~ contnIct with owner) <br />If _ S25OO. a Notice of Commet~ Is required (MectwnIca1 wortc _ $5000) <br />Supply two (2) MlII 01 drawings with appflC8ble clocumel dalIoc , <br />Allow 1~14 clays for review after submlttBl date. PIIrce1 # - obtained from Property Tax Notice (hUp:llappraiNr.pescogov.com) <br />