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'- G ` ,- ' (-, , n' ,. _ " Li :i. ZEPHYRHILLS BUILDING 'an L. N -- .i <br /> 513- 78o -0020 <br /> City of.ZephyrhillS Firre • •• 9- �" 3 Fax - 813 - 78o - 0o2i ,if <br /> Permit Application I r <br /> P hone Contact for Pemdt i L'f!% V,tle:ti • <br /> Date Received • ....: .. .....:... . .. .:: , ..... —,_ .,. • - <br /> /./ • / <br /> Owner's Phone Number VLF *57 <br /> Owners Name �L7 • . 1 <br /> / w A , / , S . 3 .353 1 Z <br /> Owners Address n 1 1 1 1 <br /> • Titleholder Phone Number <br /> Fee Simple Titleholder Name <br /> Fee Simple Titleholder Address <br /> /� m � r O Ze I i hi f 3 s- L • I 1 <br /> ` <br /> Job Address .. tQ Q� / � ,c4 _. ! 1 <br /> 1 Parcel # I <br /> Sub Division T— . <br /> Sic- Hazard Waste Storage - ANNUAL F Fumigation Tent <br /> n <br /> Comm Exhaust Kitchen Hood/Duct 71 Hazardous Material (Tier II or RQ Facility) ANNUAL • <br /> EJ Controlled Bum El. Hood installation <br /> Emergency Generator < 30 kw n LP/Natural Gas - Installation . " <br /> Emergency Generator > 30 kw • • El LP/Natural Gas-ANNUAL Sale <br /> L Fire Protection Maintenance - ANNUAL El Places of Assembly-ANNUAL <br /> ra yt 'Semi] MUT" lutner <br /> Sprinkler ./o� ID El I Recreational Bum <br /> Fire Alarm E ID ❑ ❑ i 1' n Sparklers <br /> Hood Cleaning = ❑ ❑ ❑ L. j 1 j i Sprinkler 'System Installations. <br /> Hood Suppression D ❑ . ❑ . ❑ 1 1 EJ Standpipes.(Sprinkler Sys) <br /> • <br /> Li Fire Alarm Installation ' ED Torch Roofing/Tar Kettle • <br /> f 1 Fire Pumps n Waste Tire Storage ANNUAL . <br /> Fire Works 1 <br /> Flammable Application- ANNUAL ValUa6on of Project <br /> Fuel Tanks <br /> El Other. 7 <br /> - ..:.... Company mil'!.! .r� <br /> Contractor � —de , Registered [vI Fee Current . IIME <br /> Signature�� - <br /> Address 'L'f I" ,/rime Z . / License # • <br /> � " Company <br /> EL � — Registered Y / N .Fee Current Y / N 1 <br /> • Signnature sture 1AN • <br /> Address � . License # <br /> — <br /> CvmPanY <br /> PL re Registered Y./N' Fee current _ Y/ N <br /> Signatunature _.. , <br /> Address Ucenae #. 1 <br /> MECHANICAL I Cony <br /> Signature Registered Y/ N j Fee Current 1 N J • <br /> Address __ - License # <br /> OTHER j Company <br /> Registered Y/ N Fee Current 1 Y/ N <br /> Signature <br /> License # ,. <br /> Address • <br /> Directions: <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.(Meohanical work over $5000) <br /> Supply two (2) sets of drawings with applicable documentation l/a rai asC <br /> Allow 10 -14 days for review after submittal date. Parcel # - obtained from Property T ax Notice (h ttp' pp ser .p ov,cam •) <br /> . <br /> . <br /> • <br /> • <br /> . <br />