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pti " ( Fax -893- 780 -0021 81 78 0020 City ofZephyrhills sire <br /> permit Application <br /> Phone Contact for Permit I 1 f � „ 7� <br /> Dat Rieceived . - - <br /> ... '/' ),/ Oc 2t//4 di L6 s Owner's Phone Number , <br /> Owner's Name <br /> Owner's Address <br /> 90' AA1 iLd 7 e k 4114d • C2_ <br /> Titleholder Phone Number <br /> Fee Simple Titleholder Name . <br /> Fee Simple 'Titleholder Address 8f�t�° .... • �• ^.. — J <br /> i , - <br /> :1. : I, }. :.'� "7 ,.. +gar �• wxu k a �.. -t � <br /> Af K! A 1 Y •'�,: IET,MTI.�n. <br /> Lot r <br /> ( 0 mod, <br /> Job Address l <br /> Parcel # ) <br /> Sub Division 1 <br /> f � <br /> Bio-Hazard Waste Storage - ANNUAL 1 Fumigation Tent I <br /> 1 I 1 Hazardous Material (Tier II or RO Facility) ANNUAL <br /> Comm Exhaust Kitchen Hood/Duct <br /> Hood installation <br /> Controlled Burn <br /> LP /Natural Gas - installation <br /> Emergency Generator < 30 kw ('�' LP /Natural Gas - ANNUAL Safe <br /> Emergency Generator> 30 kw 1 places of Assembly- ANNUAL <br /> Fire Protection Maintenance - ANNUAL I L.— I <br /> Magi Semi] f IUtner 1 <br /> � _ 9 Recreational Bum <br /> Sprinkler <br /> Fire Alarm 0 0 9 1 1 1 Sparklers <br /> Hood Cleaning <br /> D . . 1 1 Sprinkler System Installations <br /> Hood Suppression 0 <br /> 1._J Standpipes (Sprinkler Sys) — <br /> ,l I Fire Alarm instaliation 1 1 Torch RoofrngrTar Kettle <br /> 1 l Waste Tire Storage ANNUAL <br /> 1 Fire Pumps <br /> 1 Fire Works L'�iJ'� Valuation of Project <br /> I Flammable Application- ANNUAL <br /> I,I Fuel Tanks <br /> 1 1 Other: 1 <br /> Company LYl /�y�(�. //���/ <br /> Contractor /2 7 ��� Fee Current Y / N <br /> Y Registered / <br /> Signature <br /> Address C / 7 0 / / ) I 4 / L fia In 6 1 t / c / . T/1 -i 4 -, _ License # 1 o25 /Z OOS 1 2 0( ) <br /> ELECTRICIAN Company L Signature Registered Y / N j Fee Current Y / N <br /> Address I I License # 1 1 <br /> PLUMBER Company <br /> Registered Y / N Fee Current I Y / N <br /> Signature <br /> Address License # 1 <br /> MECHANICAL Company <br /> Si_nature Registered Y / N Fee Current Y / N <br /> Address I • License # <br /> OTHER Company <br /> • <br /> Signature Registered Y / N Fee Current Y / N <br /> Address License # �, .. <br /> Directions: <br /> FE out application completely. <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> If over $2500, a Notice of Commencement is required.(Mechanical work over $5000) <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: /lappraiser.pascogov.com) <br /> • <br />