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MAP /28/2007 /WED 07:20 AM ZEPHYRHILLS BUILDING FAX No. 813 P. 001 <br /> 813780 - 0020 City of.Zephyrhllls'Fire // 10 HO' • Fax-813-780-0021 !: <br /> Permlt Application . -- <br /> Date Received Phone Confect Por Permit I: .n.l _ } 2 <br /> Owner's Name 'IRII . S. ~r i J• Owner's Phone Number . 1 %5 J f ! . a i. Owner's Address I ( 15 ) in / 7 kid \ g , ■ - <br /> �� I Titleholder Phone Number 1 <br /> Fee Simple Titleholder Name 11 <br /> Pee Simple Titleholder Address; , _.,...Fw• <br /> Job Address (1%3% . '11.1 • � Parcel # Lot# <br /> Sub Division <br /> n Blo-Hazard Waste Storage - ANNUAL 1 1 Fumigation Tent . <br /> 1 1 Comm Exhaust Kitchen Hood /Duct : . 1i Hazardous Material (Tier 11 or RR Facility) ANNUAL . <br /> 1_1 Controlled Bum 1 1 Hood Installation <br /> 1 Emergency Generator < 30 kw 1 1 LP /Natural Gas - installation <br /> • • I 1 'Emergency Generator> 30 kw 1 1 LPINaturel Gas - ANNUAL Sala , <br /> I -- Flre Protection Maintenance : ANNUAL . I I Places of Assembly- ANNUAL <br /> c--------- _. _ w r Semi) ® Uthet - <br /> Sprinkler / ', ■ ... ❑ 1 1 Recreational Bum . <br /> ly�,q}attn — _ .-.. ..- p p' ❑ .1 I 1 Spark <br /> parklars <br /> Hood Cleaning 1 1 ❑ ❑ o 1 1 1 1 Sprinkler System Installations <br /> H'5141Pgat6 - ❑ 1 1 1-1 Standpipes (Sprinkler Sys) ° A k/ <br /> • 1 1 Fire Alarm Installation . 1' ' I Torch Roofing/Tar Kettle <br /> 1 Fire Pumps r"1 Waste Tire Storage ANNUAL 1 • <br /> Fire Works t <br /> FIemmable Application- ANNUAL I Valuation of Project <br /> Fuel Tanks <br /> ®• Other: is y ' u - ,. •. t` ..... <br /> Contractor • .. „ .. ... Company kg ii s1 r � <br /> Signature „ —. Registered mina Fee Current MEI <br /> Address W��ier Frenr.rars'M1511 % rs' • b - i . . <br /> ELECTRICIAN Company = <br /> Signature Registered • Y / N • 1 Fee Current, 1. Y / N 1 <br /> Address License # <br /> PLUMBER Company 1 <br /> Signature Registered Y/ N 1 Fee Current 1 Y / N 1 <br /> Address - J License# • • 1 . <br /> MECHANICAL Company 1 <br /> Signature Registered Y/ N 1 Fee Current Y / N 1 <br /> Address 1 I • License # 1 <br /> OTHER ' Company 1 <br /> Signature Registered Y/ N 1 Fee Current 1 Y/ N <br /> Address License # <br /> .nrwv.. ;l +:T,K•y'.. m�vm�� »Y.^T >::Cirrt^e'STr. T.:::. Y.." ".f.'.T.nw.,U is f ;T. mor -'..: .. ... ,:......'.... n !wrrn.a+r+illTa¢^n^e , ....,r evsG.ly '�'. �.r�e:.� ;n <br /> Dlrectlons'. <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 $6000) <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: / /appraiser_pascogov.com) <br /> • <br /> • <br />