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AUG /14 /2008 /THU 11:25 AM ZEPHYRHILLS BUILDING FAX No. 813-780-0021 P. 001 <br /> 813 - 780-0020 City of ZGphyrhills tka4P Fax-813.780.0021 , ;t <br /> . • Permit Application . .: a is <br /> Date Received • (:' 'Pho Contactfor Permit <br /> Owner's Name Owners Phone Number i(D�l $' 1 I L} g$ 1 EMI <br /> • <br /> Owners Addreaa o2 - .sr e 1 • . 1 r. 1. _ O O �i <br /> Fee Simple Titleholder Name _ „I Titleholder• Phone Number I , I . _,--I I ' I <br /> Fee SImple Address <br /> Job Address . ■ g : • ! V <br /> Lot �J <br /> Sub dvi.Ion Ze . y ; 1 ! � 3 354-? . Paro/s1 # ) I <br /> 0 Elio-Hazard Waste Storage -ANNUAL El Fumigation Tent <br /> D . Comm Exhaust Kitchen Hood/Duct E *Hazardous Material (Tier II or RD Facility) ANNUAL / <br /> • <br /> Conbaged Bum- 0 Hood Installation l '"p O <br /> • n Emergency Generator•< 30 kw n LP /Nattxai Gas - Installation �i a ` e- ``L7 1 <br /> ..... <br /> Emergency Generator > 30 kw t LP/Natural Gas - ANNUAL Sale , f <br /> I <br /> Fire Protection Maintenance - ANNUAL Places of Assembly - ANNUAL � <br /> Sprinkler ❑ ❑ ❑ a Reore/stionai Bum jf � j ' <br /> Fire Alarm ❑ ❑ ❑ l ..1 Spenders <br /> . Hood Cleaning ❑ t? t] n Spdnkler'Systerm Installations <br /> Hood Suppreaaion 2r ❑ ❑ re El Standpipes ( Spdnkler Sys) <br /> Fire Alarm Installation . n Torch J oafrkglrar Kettle Fire Pumps n Waste Tiro Storage ANNUAL <br /> Fire Works <br /> Flammable Application - ANNUM, - 1 ' Valuation of Protect <br /> Fuel Tanks <br /> p Other: • I <br /> Contractor , u Company ' „ „ ^ r • , 00a w 0.. r <br /> Sigr�ture � kczi Y' , . .. Registered riMall Fee Currant lffijllnll • <br /> 1 Address , - aE .M11/1_ i�t'L -- !:rcenae #_._i .. .... —1 .. <br /> ELECTRICIAN 'Company <br /> 1 Signature � _ . - . 1 Registered Fee Current IIW jai <br /> Address J - I License# - -- I <br /> I PLUMBER Company <br /> Signature • Registered I Y/ N 1 Fee Current I Y/ N 1 . <br /> Address F ----- J License* J I . <br /> 6ECHANCAL Company <br /> Signature Registered Fee Current <br /> Address I - -. -License # J I <br /> OTHER - Company r I <br /> Signature Registered ¥/ N J Fria Current L/� <br /> .Addmsa License# <br /> Directions. <br /> FIA out application completely. . <br /> Owner & Contractor /sign back of application, notarized (Or, copy of signed contract with owner) <br /> If over $2800, a Notice of Commencement is raquired.(Mec hand work over $5000) <br /> Supply two (2) sets of drawings with applicable documentation • , <br /> AIIow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notion (http:l /appraiser.paecogov.com) <br /> • <br /> I <br /> i <br /> 1 <br />