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MAR/28/2007 /WED 07:20 AM ZEPHYAHILLS BUILDING FAX No. 813 1 G F. 001 <br /> 81 ..-780-00.._ City of.Zephyrhill6'Pir, / • Fax-813-780-0021 !; <br /> Permit Application ��� �L��ry A - -- <br /> � <br /> Date Received 'Phone Contact for Permit +U J � T F F eral GS+X &A 'Lb 1 <br /> , f .�, <br /> ..��_ - Tom.,...,.•:.. ... <br /> -. .. ... -� 1 • owners Phone Number 1 I I <br /> Owners Name �(�� \):!& ��- �+i 1 . • <br /> Owner's Address . r13 0 - _ ■ ' 1 RA . r L _, - <br /> • Fee Simple Titleholder Name I Titleholder Phone Number <br /> Fee Simple Titleholder Address 1 <br /> Job Address „ r : \ a iJ _ 1 L Lot # <br /> Sub Division Parcel # �.. <br /> • <br /> FT Blo-Hazard Waste Storage <br /> ANNUAL Fumigation Tent <br /> I I Comm Exhaust Kitchen Hood /Duct . J] ' Hazardous Material (Tier 0 or RQ Facility) ANNUAL . <br /> in Controlled Bum n Hood Installation <br /> I • • I Emergency Generator < 30 kw n LP /Natural Gas- Inataltatlon <br /> Emergency Generator 5 30 Iav 1 r'INatural Gas- ANNUAL Sale <br /> Fire Protection Maintenance = ANNUAL . 1 Places of Assembly- ANNUAL <br /> . ry Ibemil rt f I Omar CJ ' -: <br /> Sprinkler U Q ❑ t� I Recreational Bum . . <br /> Fire Alarm ❑ Q ❑ 1 1 S x a 3 -R <br /> Hood Cleaning 1 1 of ' ❑ 0 1 1 n Sprinkler System Installations 1�CJ <br /> Hood Suppression ( 1 J ❑ ❑ I . • 1 . 1 1 Standpipes (Sprinkler Sys) 1 \ 1 \ 1 l„> j <br /> ' 1 Fire Alarm Installation Torch Roofing far Kettle <br /> Fire Pumps . - Waste Tire Storage ANNUAL • I' , (( Sr r <br /> �' <br /> `�j' � <br /> Fire Works • tttt ' <br /> Flammable Application- ANNUAL • .1 • Valuation of Project <br /> Fuel Tanks <br /> Other <br /> Contractor Company . a I► tR 11 It r as <br /> Registered rf ' Fee Current WEE <br /> Signature -4/Pt,d7 • • - �ry <br /> Address movent. .. • �.' r MA'l /i i I 0 - icense # 1911- G-� 1 _ <br /> ELECTRICIAN Company <br /> Signature Registered - YIN . [ Fee Current, I Y / N ( <br /> Address L , License . 4 J <br /> PLUMBER Company I <br /> Signature Registered Y / N 1 Fee Current Y / N [ <br /> Address r 1 License # •1 1 <br /> MECHANICAL Company 1 <br /> Signature • Registered Y / N 1 Fae Current [ Y•/ N 1 <br /> Address [ J • License # [ 1 <br /> OTHER Company , Mimi • - _ 1 1 - <br /> • <br /> Signature ,. � • I� ra Registered • ` ��mi Fee Current � <br /> Addres 1%1��17s' �r •'l► y� A� rN ,.. , License* ..., .. `ifi�r �6 y� <br /> A� .... <br /> ,,..� ..... ;, ".. rv�. r.:+rc•. - �_- ,:,, -.,r,a -rro xcc.,., -., ..., r.: -.�:. ,... ,.w , ..,. <br /> Direction. . b <br /> Fill out application completely. <br /> Owner 8 Contractor sign baok of application, notarized (Or, copy of signed contract with owner) . • <br /> If over $2500. a Notice of Commencement is required. (Mechanical work over $6000) <br /> Supply two (2) sets of drawings with applicable documentation . <br /> Allow 10 -14 days for review after submittal date. Parcel 4 - obtained from Property Tax Notice (http : / /appreiser.pascogov.com) <br /> • <br />