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.,,�;, 2 Y. ZEPHYRHILLS BIJILDING FAX No, 813-730-50 21 ,
<br /> 1113 - 730 -0020 City of ZephyrhilleFlie•': •.. • Fax- B13.780.0021
<br /> . Permit Application
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<br /> Date Ror:elved .: '' •Phone Contaat'for'Permit IIV ' 30'2 -) O C6
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<br /> ?v.nE. "u reams . . l •• ri • �{ J Owner's Phone Number Trt i.I `p3_4-
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<br /> .'rere 1ddresy # 15 OS t) ' , •r 1 ht1IS Fl. 33513. • ., s„„01,, - Titleholder Name __ Titleholder Phone Number 1 -
<br /> Ge Simple Address ' '
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<br /> Job Address (,feet5 _ '7 I5 thE hyr!fI . Lot*
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<br /> 'sub Givleion Parcel #
<br /> L Sio- Hazard Waste Storage - .ANNUAL
<br /> Fumigation Tent
<br /> L Comm exhaust Kitchen Hood /Duct ED Hazardous Material (Tier H or RQ Facility) ANNUAL • L J Controlled Bum 1 Hood lnetaiiation
<br /> [_J 5rnergency Generator • 90 kw • l J LP /Natural Gas - Installation
<br /> E T Prnergency Generator> 30 kw . • LP /Natural Gas- ANNU Sale .
<br /> I Fire Protection Maintenance - ANNUAL ' • ' • Places of Assembly- ANNUAL -
<br /> i__ Ib'emil En other
<br /> T o b- aka Sprinkler • ❑ 0 ❑ Recreational Burn •
<br /> F Alarm L___1 ; d ❑ O . S .4 6 / l'
<br /> V 1 Qf �� Hood Cleaning ❑ ❑ 0 • a Installation
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<br /> ® - &ym • Hood Suppression Q le a . El Standpipes (Sprinkler Sys) ,
<br /> r 1 Fire Alarm Installation • ( et e l t i t r. ) .ED Torch Roofing/Tar Kettle
<br /> ( Fire Pumps \ \\ n Waste Tire Storage ANNUAL
<br /> Fire Works •
<br /> j Flammable Application- ANNUAL I Valuation of Project I , Fuer Tanks •
<br /> Other
<br /> ..: .. , � .: , � _... , . .: ....,:.. _ ......., .... ., . ......., .,., ,. ,. .:i ce
<br /> • ;':: •rr °,:rotor , Company Fee Current -
<br /> � , , . . o, T Registered Y / N 1 1' / N
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<br /> :,.•i,.. L . a • 'i . _ � 'J • �Q u As .l.f :1 1 'License # • :.LE, • FRICIA�l Gf zo �.QZt �QpfV C Company _��� __ ......... _
<br /> `'i ''r't` "' �S E $: ?,'a 33( l y Registered Y / N 1 Fee Current L Y / N I
<br /> Address _� License #, -
<br /> PLUMBER .. Company __
<br /> :_ crler.ore T— - • . Registered Y 1 N 1 Fee Current Y I rI --
<br /> Address L License # I _ 7
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<br /> tvildCHANICAL Company '
<br /> Glgnature . Registered Y 1 Ni Fee Curre„t 1-- Y'I N�—
<br /> Address �� J 1 License tY I
<br /> 't'hf£R Company • - -_ —°�-- �_-- --
<br /> C, ;•;,ature R e g i s t e r e d Y / N lree Current Y / N 1 --- --
<br /> , darErss -'-' —�
<br /> . rcense
<br /> 1.7),:a CI � � .. ,
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<br /> FIJI out application completely. •
<br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner)
<br /> If over $2300, a Notice of Commencement ie requtred.(Mechanical work over $6000) - .
<br /> Supply two (2) sets of drawings with appiloable documentation
<br /> Allow 10 -14 days for review taer submittal date. Parcel # - obtained from Property Tax Notice (http: / /appralser.paecogov.com)
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<br /> VIGIL INC adc�fesS
<br /> P.O. ISM • Svc. fl c aul •
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