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— - <br /> 813-789-0020 City of Zephyrhills fire i eld/ <br /> 1 0 Fax-813-780-002t <br /> Permit Application <br /> Date Received 1 1 Phone Contact for Permit ,_.! lj II <br /> owners Name 1 ANDERSON PRESSURE CLEANING I Owner's Phone Number Ictl 1 1 1RALL 1 1 <br /> Owner's Address 1 5104 MURRAY HILL DR , TAMPA , PT,. 33615-4 714 <br /> Fee Simple Titleholder Name I I Titleholder Phone Number 1 11 1 1 <br /> Fee Simple Titleholder Address 1 <br /> Job Address IGOLDEN CORRAL 6855 GALL BLVD.,ZEPHYRHrLLS,FL.33542 —2576 I LOU* I <br /> Sub Division I I Parcel # I <br /> -.,:".. , - . - - - - "="Ziarri'''''ff ' ".-rattIVAralrtt=akr.i.1 ' " ' ----": - i r.7: <br /> 0 Bo-Hazard Waste Storage - ANNUAL ri Fumigation Tent <br /> ni Comm Exhaust Kitchen Hood/Duct = Hazardous Material (Tier 11 or RO Facility) ANNUAL <br /> ED Controlled Bum ED Hood Installation <br /> Ej Emergency Generator < 30 kw = LP/Natural Gas-Installation <br /> p Emergency Generator > 30 kw 1 LP/Natural Gas-ANNUAL Sale <br /> = Fire Protection Maintenance - ANNUAL [J Places of Assembly-ANNUAL <br /> r — i -. Lti 3 IMEI EEI =am I 1 <br /> Sprinkler L C 0 C I Recreational Bum <br /> ______ <br /> Fire Alarm 0 to 0 El Spariders <br /> Hood Cleaning El 0 E C 1 Sprinkler System Installations <br /> Hood Suppression E:l 0 0 0 ! I F Standpipes (SprinIder Sys) <br /> ED Fire Alarm Installation n Torch Roofing/Tar <br /> Fire Pumps Kettle <br /> = Waste Tee Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL <br /> 1 I Valuation of Project <br /> Fuel Tanks <br /> = Other 1 <br /> fiL::1,72,, Z.MMTE77.1,7: '• -.1 _-,,,,;, ..... --,-,, - ..- S' 4,... ' VZ...F1* - ........1* . 7. , <br /> Contractor Company <br /> Signature Registered Y / N 1 Fee Current 1 V / N I <br /> Address 1 <br /> 1 License # 1 <br /> ELECTRICIAN Company <br /> Signature Registered Y/N I Fee Current 1 Y/N I <br /> Address I <br /> 1 License # 1 <br /> PLUMBER Company <br /> Signature Registered Y/N J Fee Current I Y/N . 1 <br /> Address 1 <br /> 1 License # 1 <br /> - <br /> MECHANICAL Company <br /> Signature Registered Y / N j Fee Current I Y / N I <br /> Address ! <br /> 1 License # 1 <br /> OTHER Company <br /> Signature Registered Y/N . 1 Fee Current I Y/N j <br /> Addressj <br /> License # j <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with over) <br /> If over 52500, a Notice of Commencement is required (Mechanical work over 55000) <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://appraiser.pascogov.com) <br />