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<br />. ,JUL/,007/WED 01: 23 PM <br />t\ \~\},~YB~Ro-OO20 <br />\'1~,t--~1i " <br />Date Received ' ] <br />lR ~'- - <br /> <br />:,1 ; <br /> <br />FAX No, 813-780-0021 <br />. 0 db <br />City ofZephyrflills'Flr,s,. ". ~ O( <br />Permit Application <br /> <br />P, 001 <br /> <br />ZEPHYRHILLS BUILDING <br /> <br />Fax-813-76(J.{)021 <br /> <br />;w <br />_~'Jl <br /> <br />Sub Divislon <br /> <br /> <br />'Phorre Contactior Pe.mlt <br /> <br />ONner'sName <br /> <br />Owner's AddresS <br /> <br />F'EIe Simple Titleholder Name <br />Fee Simple TItleholder Addre$$ <br /> <br />Job Address <br /> <br />~ <br /> <br />. Parcel # <br /> <br />Sprinkler <br /> <br />D <br />, "D <br />D <br />D <br />D <br /> <br />FIre P~olection Maintenance - ANNUAl. ' 0 <br /> <br />".D~'~~Cj 'D R~UorralBum <br />Dp []IJc:J'O <br />~ 0 '~ci'L:]' D <br />,[S1 0 . r/ D. c::J,' 0 <br />D <br />C]. <br />l '7t1~~ I <br /> <br />Fumigation Tent. <br />~rdoui; Materi8J (Tier II or RQ facility) ANNUAL <br />Hood InstiIUaOon <br />l.p/Natuflll Ga~""lallanon <br />l-P/Natwal Gaa-AN~UAL sale, <br />Plaeea. ofAssembly-ANNUAL . <br /> <br />o <br />o <br />o <br />D <br />B <br /> <br />.. ' <br />Blo-HaDrdWaste Storage ..ANNUAL <br />I ',:' . <br />Comm ,Exhaust KItchel'! Hood/Duct <br />ConlroUed Bum <br /> <br />. . <br />Em",rIiency Ge"",rator < so kW <br />Emergency Gene",wr> ao kw <br /> <br />'. . <br /> <br /> <br />Hood Cleaning <br /> <br />HoOd 5uppres5lon <br />Rre Alarm Installation <br />I"lre ,Pumps <br />Fire Wor\(l; <br />Flam~ble Appllr.atlol}o AtmuAi,.' <br /> <br />FIleI Tanks <br />Other: .. I <br /> <br />Sparlders <br /> <br />Sprinkler S~'lnWillatlcifl$ <br /> <br />;;:tandplpes '(Spa1nkler ~) <br /> <br />Torch RoolingJTar Kettle <br />,Wal!te 11re Stor,lge ANNUAL <br /> <br />Fire Alan:n <br /> <br />Valuation of Project <br /> <br />Contractor Company <br />Signature ; Reglster9d <br />Addrelllil ~[L~cElf!~.#_.. <br />ELECTRICIANI :J CoMp;;lnY. <br />Slgnatul'e . FWglstered <br />.Address I ~. ucense# <br />pLUMBER I ., 1 Company <br />Signature Fl.8glsterad <br />Address L -:J License # <br />~ECHANICALl ;] , Company <br />SIgnature Registered <br />AddresS I ' ~ 'LicElnse 1/; <br />OTHER I i Company <br />Signature , ; Regl;,tsred <br />Address __ l.icense # <br />tireetlona: - ~ <br /> <br /> <br />J <br />I <br /> <br />Y I NT Fee CufTBl'll <br /> <br />~ <br /> <br />~ <br /> <br />Fee Current <br /> <br />I Y/N I <br />~ <br />LY/NJ <br />J <br /> <br />~ <br /> <br />Fee Current <br /> <br />.ih - ,'" <br /> <br />IT <br /> <br />Fill out applicat10n c:ompletely, . <br />OW""r & ContrBctor sign back 01 application, n~ (Or, copy of slgl'leld contraot with owner) <br />If over $2500, a Notice 01 Co~nc8fl1lM\t I, requlred .(Mechanlcal work over $5(00) . <br />supply two (2) seb; of drawings with appncabl& docuJTl8ntatlon . . . <br />Allow 10-14 days for review after ,...bmntal date. " Parcel # - obtained from PropBl1y Tel{ Notice (htlpJ/appra\ller.par;cogov.com) <br />