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813- 780-0020 City of Zephyrhills Fire 46106 Fax - 813 - 780 -0021 <br /> Permit Application <br /> Date Received <br /> Phone Contact for Permit (, <br /> Owners Name 1 I ANDERSON PRESSURE CLEANTNG 1 o wners Phone Number IR �- I (RR4 _ 1 5�(1R <br /> 1� <br /> Owners Address 5104 MURRAY HILL DR, TAMPA, Fr,.13€s1 S -4734 <br /> Fee Simple Titleholder Name I I Titleholder Phone Number I <br /> Fee Simple Titleholder Address I <br /> __ m_r:'Mr'' rte *„ -,- EWA:.�:74r ";':"a' .... i , ': - )IYPIN- ',_.''rm'IV'�s - 'r,T_ -T M _ M.- ---M.`_z^. '._ti ,".- ,.; _ ":si.. _ F.. z..c, - _-- ..:, _., - - t — *V.%".' - i <br /> Job Address 'GOLDEN CORRAL 6855 GALL BLVD. ZEP 4;_,I! - • Lot# I <br /> Sub Division 1 Parcel* I <br /> _ -- 'c: H- T- xe, .?'_, - rk = r4 riw e:v, °" 'T` .. . m.a.,.. ...:, _ Yx. ....t - , :g. - ,=z..... -..�F s. -. ._ _mom ""5.;- .., .� .. _ _ <br /> Bio- Hazard Waste Storage - ANNUAL Fumigation Tent <br /> ® Comm Exhaust IGtchen Hood/Duct ED Hazardous Material (Tier II or RO Facility) ANNUAL <br /> Controlled Bum fJ Hood Installation <br /> rI Emergency Generator < 30 kw n LP/Natural Gas - Installation <br /> n Emergency Generator> 30 kw LP/Natural Gas - ANNUAL Sale <br /> CD Fire Protection Maintenance - ANNUAL I-I Places of Assembly- ANNUAL <br /> L ! ® tm,er <br /> Sprinkler ?= G G n Recreational Bum <br /> Fire Mann 0 G M ( [] Sparklers <br /> Hood Cleaning i E= c C ( ( F <br /> Sprinkler System Installations <br /> Hood Suppression C 0 ' I a Standpipes (Sprinkler Sys) <br /> 0 Fire Al arm Installation = Torch Roofing/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL i 1 Valuation of Project <br /> Fuel Tanks <br /> Q Other. I <br /> Contractor Company <br /> Signature Registered Y / N j Fee Current I Y/ N I <br /> Address ( I License* I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N j Fee Current I Y/ N I <br /> Address I License # I I <br /> PLUMBER Company <br /> Signature Registered Y/ N j Fee Current I Y/ N I <br /> Address I I License # I <br /> MECHANICAL Company <br /> Signature Registered Y / N 1 Fee Current I Y/ N I <br /> Address I License # I <br /> OTHER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address <br /> . �:,� � ,..:.,�,_� r. ,. _.:,.: s �.w -= ...ate- �._.Y�.�:,�;;.,.�.� -.:... �.�.r•.� .- ^-� <br /> tense # <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 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 l /appraiser.pascogov.com) <br />