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r "G/10/2008 /SUN 11:15 AM ZEPHYRHILLS BUILDING FAX No. 813 P. 001 <br /> • <br /> 813-700-0020 C OfZe h <br /> • <br /> City p yrhills'Fi1id.- • Fax -813- 780 -0021 <br /> J Permit Application <br /> Date Received o C l� Phone ContaetforPennit <br /> Owner's Name I .Z,,CANy4 HrcC S 11 -KS L04€ _ 2.7 3 I I Owners Phone Number .I S /3 117 8 G I 14604- <br /> Owner's Address 1 6 85 £tl. 4 K R a Pi - r <br /> Fee Simple Titleholder Name • I W G s S v Sp sic ; e.J �Zt y.t j S, LL-L•1 Titlehoder Phone Number 1 2.1 1 I s. S S I 146/9 <br /> Fee Simple Titleholder Address I P o 6 plc / 6 2-o L•o. t G ' /'4 3 3 7 '79 _ 111 <br /> Job Address' I 68.6"7 . 1,114.!. . /C o .s 4 L <br /> 1 Lot# <br /> Sub Division I Parcel # I <br /> Ii Blo-Hazard Waste Storage -ANNUAL J <br /> 1 I Fumigation lent • <br /> •A <br /> Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RC Facility) ANNUAL <br /> n Controlled Bum. El Hood Installation <br /> . ` Emergency Generator < 30 kw • • • • n , LP/Natural Gas- Installation <br /> Emergency Generator > 30 kw LNatural n 1 / ® t•.= 9 <br /> Sprinkler ❑ d ❑ k{ a Recreational Bum • ' <br /> • <br /> Fire Alarm I ' p • ❑ p El Sparkle <br /> Hood Cleaning I ] ❑ 0 • 0 J s n Sprtrdder System Installations <br /> • <br /> . Hoad Suppression E in ❑ o ( 1 El Standpipes (SprknklerSys) <br /> • <br /> Q( l Fire Pumps Fire Alarm Installation ��''``''�� Torch Roofing/Tar • <br /> l 1 ' tor Kettle ' <br /> I f 1 Waste Tire Storage ANNUM <br /> Fire Works <br /> - HI Flammable Application- ANNUAL <br /> Fuel Tanks sr 2 op, er 'Valuation of Project <br /> F Other: o4..., cit.( � 9» —'N L 1N . <br /> a/ fTlfi '. Sni -r, ©.✓ I <br /> Contractor � ' C W SC -o+�AC74 LLC <br /> Signature ‘. ( sl�lN. I <br /> Registered Y! N 1 Fee current ( Y/ N 1 1 <br /> Addree 20'$ 712o0.c '4v4 .,c, L.o,apor / 3.3770 I <br /> •I • Ucense# • j ‘2386 /tool <br /> ELECTRICIAN' 1 <br /> _ <br /> Signature • Company 1 <br /> • Registered • • Y / N ' 1 Fee Current 1 Y / N ' <br /> Address I <br /> 1 , • License # I <br /> PLUMBER I - <br /> • <br /> Signature l Company <br /> Registered Y N Kee Currant Y/ N 1 <br /> Address I • . <br /> (• License # L - 1 <br /> MECHANICAL <br /> Signature Company • I <br /> • • <br /> - Registered -Y/ N 1 Fee Current 1 Y/ N 1 <br /> Address 1 1 <br /> License # I <br /> O <br /> 1 <br /> THER • <br /> Signature .. • Company 1 <br /> • <br /> • - Registered I . Y/ N J Fee Current 1 Y/ N 1 <br /> Address <br /> Directions: License # <br /> Fill out application completely. • <br /> Owner & Contractor sign back of application, notarized (Or, copy of elgned comma with owner) <br /> If over $2500, a Notice pf Commencement Is regulred.(Mechanical work over $6000) <br /> Supply two (2) sets of drawings with applicable documentation - <br /> Allow 10-14 days for review after submittal date. Parcel # - obtained from Tax Notice <br /> �opertY (hltpJ /appnaissr pasco9ov.com) ' <br /> • <br /> • <br /> • <br /> • <br /> • <br /> • <br /> • <br />