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FB/20/2007/TUE 11:10 AM ZEPHYPHILLS BUILDING FAX No, 813 - 780 - 0021 P. 002 <br /> - 81 3-780=0020 • City of.Zephyrhills lC ez : • -Fax -813 7800021 • - - 4... <br /> Permit Application ;.'i"` <br /> _ • <br /> •.. reza pp • • . horioC ontactfor <br /> _Date Received .. ooze - R .... . <br /> F Permit <br /> p - owner's Phone Number I!v Y.2 13 Q6'1 - <br /> Owner's Name • -•�L -,..,_,f. ' �/ <br /> Owner's Address io ....C/ .J Al .e) Ar . � ft • i I s 7 3 2- 2 y Co tI <br /> . • i Titleholder Phone Number I 11 I I J <br /> Fee Simple Name -- - <br /> Fee Simple-Titleholder 1 • <br /> A IWJF 1 L . al l / /• a • /0 Lot # I' i <br /> Job Address p f /� <br /> Subbivlslon lAr c if 70 O' • 'Z • 1 • <br /> Bio-Hazard Waste Storage - ANNUAL • ' n FumigationTent • <br /> Comm Exhaust Kitchen Hood /Duct in Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> 1 1 Controlled Biim I I Hood Installation <br /> n LP /Natural Gas - Installation r • <br /> ' Emergency Generator c 30 kw 1 <br /> +m <br /> E er g e n c y Generator S0 Kw • LP/Natural Gas-ANNUAL Sale / n <br /> I I Pire Protection Maintenance - ANNUAL 1n - Places of Assembly- ANNUAL �(f <br /> • I Isamu F E iutne( 1 • Sprinkler J Q 1:1 ❑ Recreational Bum, . <br /> • Fns Alarm ' ri ❑ ❑ ❑ ' . • I . n Sparklers . • <br /> Hood Cleaning pp Y 1 • ❑ ❑ I 1 n Sprinkler installations . <br /> kler Sys <br /> u <br /> Hood Suppression Q f7 Q I I n Standpipes (Sprinkler Sys) - <br /> ' . `• 1 Fire Aiarrh inatellation • • . f1 Torch Roofing/Tar Kettle • • <br /> • • <br /> • Fire Pumps n Waste Tire Storage ANNUAL • <br /> Fire Works • • I V aluation of Project • <br /> Flammable Appllcallon- ANNUAL. ' • • <br /> n Fuel Tanks I <br /> In Other: I <br /> Contractor C ompany <br /> Signature Registered Y / N ( Fee Current 1 Y/ N I <br /> • <br /> • Address 17-7- _License.# .. j • <br /> ELECTRICIAN^ 1 Company <br /> • <br /> Signature . I Registered Y/ N I Fee Current Y/ N 1 • <br /> Address -1' License # j <br /> • PLUMBER I 1 • Company I <br /> Sic tature Registered Y/ N I Fee Current I Y i N 1 • <br /> Address 1 . _ • ( •• License # I • <br /> M`HANICAL Company • <br /> Signature Registered . Y / N Fee Current M-7 • <br /> Address .License # . ( . • - .. 1 • <br /> OTHER . • . Company • <br /> Signature . ' Registered Y / N - 1 Fee Current I Y / N <br /> i s 1 I License# <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contraot with owner) <br /> If over $2500, a Notice of Commencement Is required .(Mechank al work over $5000) , <br /> Supply two (2) seta of drawings with applicable documentation . <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (httpJ /appreiser.pascogov.com) <br /> • <br /> • <br /> • <br /> • <br />