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Dec 17 2009 01:49 PM DUNNWELL 9192474973 <br /> .J.Mq0(/ 2/2 <br /> DECD 06 /2007 /THU 04:22 PM ZEPIIYRHILLS BUILDING FAX No. 013 I P, 003 <br /> ' 813-700 -0020 . City of.Zephyrhllls Flre I Fall -513- 7804021 <br /> • •Permft Application _ <br /> Date Received _ 1 ' --• Phone Contact for permit IG'21 111 00. <br /> • <br /> Owner's Name • I 11 1 1,' 1 owner's PhoneNumber 1 a 13 1 [ 188 1 f b3IS <br /> • <br /> opine s Addcoss 1 1 (0 4 clecii glum - ze- N q rinl lls-.�� ..._ 5 __.$ 4 / 4131 - J <br /> Fee Simple Titleholder Name 1 1 TlUeholder Phone Number. 1 • . 1 ` J I • <br /> Fee Simple TitleholderAddrc=s _ , . <br /> Job Address • I - i • , Lot# I • <br /> Parcel <br /> Sub Division u�n rrt u rcm r IAA rvui1a41 <br /> t3laHazard Waste Storage - ANNUAL • • D Fumigation Tent <br /> ❑ Comm Exhaust Kitchen Hood/Duct • • . 1=1 He:andoua Material (Tier 11 or a4 Fadilt) ANNUAL <br /> ❑ Controlled Bum - El Hood IitotallaUon <br /> ❑ • 'Emergency Generator <30 kw ' ❑ LP/Natural GarelnatnllaUon . . <br /> ❑ Emorgency Generator> 30 kw . ❑ LP/Natural Gas - ANNUAL Salo l iS <br /> ❑ Plre Proteclon Metntenance - ANNUAL • ❑ Places or Assembly-ANNUAL , I1 1 <br /> Sprinkler Recreational Bum ; f I <br /> • Fire Alan - • ❑• Sparklers Hood Y4i/ C CteaniS Er =1 Sprinkler System Installations • <br /> Oppression , <br /> • <br /> .❑ 'Fire Alarm Installation • • -. - 0 Standpipe (Spdnklor Sys) . <br /> Fire Pumps ❑ Torch Roofing <br /> . ❑ Fite Works • - • , • p Waste Tire Storage ANNUAL <br /> =1 Flammable Application- ANNUAL • • • <br /> • ❑ Fuel Tanks ' ' . <br /> anks . i Valuation of Project <br /> ❑ Other: <br /> conuactor company +� . • .17;11' <br /> Signature E�C � 01 s . Registered • ' Fee cunent Y / N <br /> Address •J --- License # • r 1 1 <br /> t1ECMRICIAN - • . . cempany • 1 • • Signature Registered Y/ N 1 Fee current L- Y/ N) <br /> Address 1 j License:/ ( ' . I <br /> PLUMBER Company • : • • <br /> ' Spnature ' J 'Registered . Y / N ( Fee Curr nt J Y / N 1 • <br /> Address J J. , ticoOseiiR • 1 <br /> MEGHANICAL company <br /> • <br /> 'Signature . j • Regtetorod. f Y 1 N J• Feo Curre [ Y/ N 1 • <br /> Address 4 • - License# ( 1 • <br /> OTHER Company - <br /> . Sipnelura _ . - Registered 1 Y /_N J Fee Current 1 Y / N l <br /> Addraon License it ' i <br /> • RI out appetaeon completely.. . <br /> Owner & Contractor sign bock of e{tpliceUon, •r otartzed (Or, copy Woking* eoniroet with owner) • <br /> IF over $2600. a.Notice of Commencementls requmd (Mechanical work over $5000) <br /> - Supply two (2) gels of druwirgaUh applicable documentation . - <br /> Allow 10-14 days for revirmafer submittal date. • - • <br /> • <br />