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FED /20 /2007 /TUE 11:10 AM ZEPHYRHILLS BUILDING FAX No. 813 P,002 <br /> '813:780 =0020 • City of.ZephyrhillSFirii,-0o?^ :Fax-813-780-0021 • • •:if ; <br /> Permit Application -• -• adiic <br /> Date Received • • P ho Contact for Permit <br /> Ownsr'sName_ --- J , :f�r.— iPe 's'��4i •_ Owner's Phone Number 99 / 1 ` � 5/Z 306' ....._ <br /> Owner`s Address . /v 5, J 1 .0 S 1 / :f 7 J 2 y to <br /> 4r • <br /> Fee Simple Name • . Titleholder Phone Number ( ' <br /> Fee Simple Address <br /> � ... !w d .. - ....... _.. .. <br /> Job Address . . . , i _ / /// �/ / _ �► ^__ Wm / Lot # _ <br /> Subblvlslon 1i Parcel <br /> ■ <br /> E Bio- Hazard Waste Storage - .ANNUAL •• • - ' • n Fumigation Tent ' • • , <br /> 1 1 Comm Exhaust Kitchen Hood /Duct I I Hezardoue Material (Tier II or RQ Facility) ANNUA . <br /> I ' Controlled Bum Hood Installation • <br /> Emergency Generator c 30 kw LP /Natural Gas- insta I I 1Iatlon le <br /> Ti 1]� <br /> • 1 ' Emergency Generator ? 30 kw LP /Natural Gas - ANNUAL Sale I <br /> Piro Protection Maintenance - ANNUAL ' " I. 1 - Places of Assembly-ANNUAL • <br /> . 177171 LSamI I IAN I tithe Sprinkler ' • 1 Q I7 ❑ Recreational Bum . <br /> Sparklers . <br /> Fine Alarm • El ❑ O ❑ . ... I . I- I P ' • <br /> • Hood Cleaning it ❑ - ❑ I I I • - I Sprinkler System Installa - <br /> . •• - Hood Suppression I • 0 r] i0 I • I I I Standpipes (Sprinkler Sys) <br /> ' • I 1 Fire Alarm Installation . I I Torch Roofingffar Kettle . . <br /> Fire Pumpa • 7 Waste Tire Storage ANNUAL <br /> Fire Works ' • ' • . • • <br /> Flammable Application ANNUAL . 1 I Valuation of Protect • • - <br /> • <br /> • <br /> 1 .Fuel Tanks . . . • <br /> .. I <br /> Other: <br /> i <br /> Contractor • . Company _. -1 <br /> Signature Registered Y/ N 1 Fee Currant I Y/ N I • <br /> • <br /> Address I" • .. . . . . ....1 _ License #- .I. 1 . <br /> ELECTRICIAN • Company 7 <br /> signature - Registered Y I N I Fag Current -I Y/ N I • <br /> Address I —1' License # ( I <br /> PLUMBER . . • . . . Company <br /> 1 <br /> Signature Registered Y/ N I Fee Current I Y / N <br /> Address I _ • I License # • <br /> MECHANICAL Company 1 <br /> Signature Registered . Y / N I Fee Current Y/ N 1 <br /> Address I 1 1. . <br /> -License # . I . <br /> • • <br /> OTHER . • company I <br /> • <br /> Signature Registered Y / N • I Fee Current .I Y / N <br /> Address Llcenee # <br /> Directions: <br /> Fill out application completely. <br /> • <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 .(Mechanlcal work over $5000) <br /> Supply two (2) sets of drawings with applicable documentation . <br /> Allow 10 - 14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http: / /eppraiser.pascogov.com) <br /> • <br />