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.FEB /?0 /2007 /TUE 11:10 AM ZEPHYRHILLS BUILDING FAX No.813 780 - 0021 P. 002 <br /> '813=780'0020 • City of.Zephyrhill5' n loo ^^ • :Fax- 813 - 7800021 ......:g <br /> Permit Application ', -. -• . • •••a3iic <br /> Date Received o <br /> P e Contact for E'ormlt • <br /> l <br /> Owner's Name — , 1 / _. :>, 1 S , eG` / - .. -, Owner's Phone Number , 9© `/ 1 '2 _ 3�ac6 .I ....- <br /> Owner's Address 2 � S/ J " ..U.S ,r;_ •f .. • . � i i 7 � � 2 lv <br /> Fee Simple iltleholder Name Titleholder Phone Number <br /> Fee Simple Address <br /> ��} .. r.5 .. .', ._...a.. � ' __.�...' .:. - i < .:ti... .�,. rt'.. .. q. .. -m_di_ .._ .... <br /> Job Address �� / fie' /�� _ ���'a o 1 4 Lot# _ <br /> • <br /> Sub"Dlvlsion ' 11, /r�i I _ I Parcel # r ` <br /> Bio- Hazard Waste Storage - •ANNUAL •' • • I ' .I Fumigation Tent ' . • • n Comm Exhaust Kitchen Hood /Duct r Hazardous Material (Tier II or RQ Facility) ANNUAL . <br /> I I Controlled Bum 1 I Hood Installation /� , f <br /> f - Emergency Generator < 30 kw . n LP /Natural Gas - Installation (� ! I f <br /> • 1 1 • Emergency Generator P 8o kw . n LP /Natural Gas - ANNUAL Sale. `� <br /> Fire Protectioh Maintenance - ANNUAL - .' I. 1 • Places of Assembly-ANNUAL <br /> ' . )wrrrfl [ emrl Aril I tither <br /> • Sprinkler I: la ❑ ❑ n Recreational 6um - <br /> Fire Alarm ' El ❑ ❑ ❑ L__. . I .. } Sparklers . • • <br /> Hood Cleaning [><1 » ❑ ❑ I I I Sprinkler System Installations . <br /> Hood Suppression I I' Q ❑ .0 I • • • I l Standpipes (Sprinkler Sys) <br /> 1 I Fire Alarm installation ( Torch Roofing/Tar Kettle . <br /> Fire Pumpe . . - • I Waste `tire Storage ANNUAL <br /> Fire Works ' • - . . • .:. . <br /> • <br /> Flammable Application ANNUAL . j Valuation of Project • <br /> • <br /> I I ,Fuel Tanks . - , <br /> El Other: I_ • <br /> Contractor - Company <br /> Signature L Registered' Y/ N I Fee Current I Y/ N I <br /> Address I • . .. . . ... j License # . J . <br /> ELECTRICIAN Company • _ 1 <br /> Signature Registered Y N I Fee Current 1 Y/ N I • <br /> Address License # _ ] 1 • • PLUMBER - • . . . • Company _ - 1 <br /> Signature Registered Y / N I Fee Current .1 Y / N <br /> Address License # I 1 <br /> • <br /> MECHANICAL • Company • I <br /> Signature Registered . Y / N 1 Fee Current Y-/ N I <br /> Address . . I .License # . I . 1 <br /> OTHER . Company <br /> Signature . • Registered Y / N . I Fae Current ' 1 Y / N 1 <br /> Address � Ucenee # 1 <br /> wr <br /> Directions: <br /> Fill out application completely. . <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) • <br /> if over $2500, a Notice of Commencement Is required.(Mechanical work over 85000) , <br /> Supply two (2) sets of drawings with applicable documentation . • <br /> Allow 10-14 days for rovlew after submittal date. Parcel #- obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br /> • <br /> • <br /> • <br /> • <br />