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, 'CT c'' 2 r7%Ti?E' 11 27 AM. ZEPHYRHILLS BUILDING F . x' 7r 0,1'2_70 <br /> 813-780-0020 City .. ofZephyrhillsFIIe 4-q7/b( Fax- 813- 780-0021 <br /> Permit Application <br /> r - <br /> Date Received - P hone Contact for Permit aM- Y MIMI <br /> Owner's Name d -4-� VO`S� b ^ n , V Owner's Phone Number T - I • Owner's Address . 3b \ Ci� ? t ` \ l�,..2:. \ _ _ . . <br /> Fee 5lmpte Titleholder Name 1 T itleholder Phone Number 1 • <br /> Fee Simple Titleholder Address <br /> { 1 1 \ f _ Lot # <br /> Jab Address .. 3�� b k C \ / i � 2��{� L . -c� • <br /> Sub Division I. . Parcel # <br /> • 0 Blo- Hazard Waste Storage - ANNUAL ( Fumigation Tent - <br /> r Comm Exhaust Kitchen Hood/Duct Hazardous Material (Tier H or RR Facility) ANNUAL • <br /> Controlled Burn • n. Hood Installation . <br /> ' Emergenc Generator a 30 kw . n LP /Natural Gas - installation <br /> h Emergency Generator> 30 kw El LP/Natural Gas - ANNUAL Sale • <br /> Fire Protection Maintenance - ANNUAL , • <br /> rdt places of Assembly- ANNUAL • <br /> Ty� em ({t <br /> • Sprinkler ED ❑ 17 ❑ r her _ ' n Recreational Bum <br /> Fire Alarm 0 fl l9' I I n S parklers <br /> Hood Cleaning ❑ . ❑ .0 1 E Sprinkler System Installations, <br /> • <br /> Hood Suppression ❑ ❑ 0 a Standpipes. (Spr{nkler Sys) <br /> Li Fire Alarm Installation ED Torch Roofing/Tar Kettle • <br /> • <br /> n Fire Pumps 71 Waste Tire Storage ANNUAL . <br /> c <br /> Fire Works <br /> Flammable Application- ANNUAL Valuation of Project <br /> Fuel Tanks <br /> n <br /> Other. • <br /> Contractor �~ Company (7) - o f r <br /> Signature -P-'�\ Registered I o ti Current . / N <br /> ��ZS� +. License #. _I Addre�s "3 S 3 ..- <br /> r L�� _ <br /> ELECTRICIAN • - 1 ' Company • . ___I Signature Registered Y/ N I .Fee Current I • Y / N II <br /> • Address ( License# [ J • <br /> . PLUMBER , <br /> Signature Registered Y./ N I ,Fee Current , YIN <br /> Address 1 . • . I • License #. I .. <br /> MECHANICAL Company <br /> Signature . 11 Registered Y / N . 1 Fee Current / N 1 • <br /> Address I' I - License #• E 1 4 <br /> • OT�11 R Company . �J <br /> • Signature Registered — Y / N I Fee Current 1 Y/ N I <br /> Address . . Llcenee # . • <br /> . rn. wr•: r+ rrsrm•. :.- ..,,!xc.,;a�.�.,,.- .., -„n, _ ..... .... _.,..,,.-.: _ .,:,u+ -.. _-r,., roT-... sr., ti ._.... <br /> b1rectiona: • <br /> Fill out application completely. <br /> Owner &Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> . If over $2500, a Notice of Commencement is required, work over $5000) <br /> Supply two (2) sets of drawings with applicable documentation <br /> Allow 10 -14 days for review after eubmittal date. Parcel # - obtained from Property Tax Notice (httpJlappraiaer.pascogov.com) <br /> • <br /> ' <br />