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X13 /2008 /SUN 04:13 PM ZEPHYRHILLS BUILDING FAX No. 813-780 -0021 P. 002 <br /> 813- 780 -0020 Clty ofZephyrhIUsFit - •• Fax- 813 - 780-0021 <br /> Permit Application . <br /> Date Received • �_ � •_•- :Phone •Contact•for Permit <br /> Owner's Name ) ?C. Q P Ve S. ■4 L1 Co( P I Owners Phone Number 1 J • 1 11 .) <br /> Ownere Address • L 5 2l 1 c All a\va ? -4.PhY 4 hAS, FL• '6354Z . ( <br /> Fee Simple Titleholder Name • L 1 Titleholder Phone Number I • 11 II I l <br /> Fee Simple'fltleholder Address I <br /> Job Address 1. .5 l"1 G j( 31vd 2 FL' 33542... '• I Lot # . I • . 1 • Sub Division I Parcel # j <br /> 1 <br /> n Elio - Hazard Waste Storage - .ANNUAL ' .' Q Fumigation Tent . <br /> 0 . Comm Exhaust Kitchen Hood/Duct . I_.J Hazardous Material (Tier II or RQ Facility) ANNUAL .. • <br /> ❑ Controlled Bum• 1 ---- i Hood Installation • <br /> ❑ Emergency Generator 30 kw LP/Natural Gas - Installation qi � <br /> . 1 - 1 Emergency Generetor> 80 kw J . • . .. . ❑ LP /Natural / atural Gas•ANNUAL 0 / a C <br /> gET Fire Protection Maintenance - ANNUAL E:1 Places of Aeeambiy N <br /> -ANU <br /> Sprinkler ❑ Q O .0 ❑ Recreationallgum. D / 6 <br /> • Fire Alarm ' El 0 O r ❑ ' ❑ Sparklers C C` ' <br /> - . <br /> Hood Cleaning ❑ O O 0 Spnnkler'System Installations • <br /> • • Hood Suppression ❑ O O O Standpipes (Sprinkler Sys) <br /> ' • 1l Fire Alarm Installation • . • • • l l Torch Roofing/Tar Kettle <br /> R . Fire Pumps • . • • • • • . ❑ Waste Tire Storage ANNUAL .. .. , • <br /> Fire Works . • .. . . • . • <br /> R Flammable Application- ANNUAL .I 1 Valuation of Project • Fuel Tanks <br /> 0 Other. <br /> Contractor . Company 1 •Signature , • _ Registered [ Y/ N j Fee Current 1 Y / N 1 • <br /> Address 1 1 • ._ Ucense #.. I 1 . - <br /> ELECTRICIAN • . . • • Company 1 <br /> Signature _ • Registered Y / N Fee Current 1 Y / N <br /> Address I 1 .. License # I 1 <br /> • <br /> PLUMBER . • • • • • 'Company 1 <br /> • <br /> Signature • • • • Registered I Y / N 1 Fee Current 1 Y / N ( . <br /> Address 1 • 1 License # 1 1 . • • <br /> MECHANICAL' Company . ' <br /> Signature . Registered [ Y / N ( Fee Current 1 Y• / N 1 ' <br /> Address 1 ' 1 • Ucense # . • • 1 <br /> OTHER `,� O <br /> Company Mvc tn o S6C rt +`� ru <br /> Signature e--‘1•94.,/ ' - H" • , ' Registered Y / N _1 Fee Current 1 Y / N <br /> .Address _'�.�:,.. • _ • Ueense# 1 <br /> • • irectlons: <br /> Fill out application completely. • • <br /> Owner & Contractor sign beck of application, notarized (Or, copy of signed contract with owner) • <br /> Prover 52500, a Notice of Commencemem le requlred.(MechanIceI work over 36000) • • <br /> Supply two (2) sets of drawings with applicable documentation . • • <br /> Allow 10 days for review after submittal date.' Parcel # -.obtained from Property Tax Notice (httpJ /appreieer.pascogov.com) . • <br /> • <br /> RECEIVED 07 13 -'09 15:56 FROM- ' 8137800021 TO- Devcon Security P002/002 <br />