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.... _ �J'_'7, i?'.i `79:21 AM ZEPHYRHILLS BUILDING FAX No, 813 - 737 -7121 F, 07: <br /> 013 - 780 -020 City ofZephyrhills'Flito: .17( v Fax- 813.780.0021 <br /> . Permit Application <br /> Dare itioG ,. ` Phone Contect•for Permit I' �. • <br /> Ov;neri Nam ■ g,/ f r Owner's Phone Number 3 3 J 3 1 I?o5 1 ow <br /> ••nera Add,. . '" Ave �% '�� 4L. 3 1 <br /> Fee Sample Titleholder Name Titleholder Phone Number 1 , [1_ <br /> Fos Simple Titleholder Address - <br /> ( - 41 Lot* 1----1 <br /> Job Attrrvss ._ - -- - -- - - <br /> Sut. blvision Parcel tf J <br /> E3 Bio- Hazard Waste Storage - ANNUAL Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct 0 Hazardous Material (Tier 11 or RQ Facility) ANNUAL <br /> L7 Controlled Bum l f Hood installation <br /> E Emergency Generator 30 kw • - LP/Natural Gas - Installation <br /> v,. Emergency Generator> 30 kw LP /Natural Gas- ANNUAL Sale . <br /> I t Fire Protection Maintenance - ANNUAL • . Placer: of Assembly- ANNUAL • <br /> EMI ® ®"Omer . <br /> S d l eCtO ) Ed Sprinkler O ! D Ruci aUonal Bum • Fire Alarm . O D t] ' Sparklers <br /> Hood Cleaning 0 Cl 0 1 Sprinkler System Installations • <br /> I I •M 0 Pf Q Standpipe! (Sprinkler Sys) , <br /> ri Fire Alarm Installation . Torch Roofing/Tar Kettle <br /> Fire Pumps ` Waste Tire Storage ANNUAL <br /> Fire Works . • <br /> Flammable Application- ANNUAL ' .1 ValUatlon of Project <br /> Fuel Tanks <br /> Other: <br /> c,.n, actor • Company 1 <br /> 5ipnat ire Registered Y / N 1 Fee Current ( Y / N J <br /> +d1rdas SiIMIIPW ! L . rIMilli , license # _ 1 . . <br /> ELL.C. CIA I 1 ../ Company 1 <br /> 5i L Registered Y / N 1 Fee Current L Y/ N 1 <br /> Ad,Jr955 - License #, <br /> PLUMBER . • . Company <br /> • <br /> igna`srre ��. Resieterod WIEN Fee Current IMO <br /> Address 1 License* . I <br /> -^—"` <br /> M,�.'CHANICAL Company <br /> Signature Registered MEI Fee Currant IlliTEll <br /> Address 1 . . 1 License Al J • 1 • <br /> ;rrFtEtt Company - <br /> S, :•:lature Registered • Y / N [ fee Current 1 Y/ N J <br /> h Li cense # <br /> on actions: ..,- <br /> Fill out application completely. • <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> t* over $2300, a Notice of Commencement le require�dl.(Mechanical work over $5000) <br /> Supply two (2) sets of drawings with applicable documentation . • . <br /> Allow 10 - 14 days for review after submittal data- Parcel # - obtained from property Tax Notice (http / /apprafser,pascogov.com) <br /> U l I LL V�� �� f ST ec m o L . -b . Po b X 3 . • -(, <br /> 1 r,,,,, 1 �L 3 3 L j C1eoMi�,y c oM ' <br /> • <br /> 813 q 3.)-9 too <br />