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813-780-0020 City of Zephyrhills Fax-813-780-0021
<br /> Permit Application
<br /> Date Received :-• Phone Contact for Perrnit I
<br /> ____. - -
<br /> Owner's Name •S TMPT,F,XGR TNNELL Owner's Phone Number 813 626 5482 -
<br /> Owner's Address 4701. Oak Fair Blvd TAMPA FL 33610
<br /> Fee Simple Titleholder Name 1 - - I tleholder Phone Number
<br /> Fee Simple Address - .
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<br /> • 41
<br /> Job Address 7 • 00 4 rl-ve_ 5 Li 2. . - . - - 0 a
<br /> e Lot*
<br /> Sub Division Parcel #
<br /> SOMMINDMEMEgagge-, = ,-, nr-t , "=' , ..- , „• , -.Z.'V , ,, , , ' , `- i S, ::,......., ,. .-41..,V: 31.,...A., ..",',V.W...W. ."--", " ,,_,.. , ,,,,,,,,,,,,,,.... ,,,itt,....
<br /> 1 • Bio-Hazard Waste Storage - ANNUAL I Fumigation Tent
<br /> I Comm Exhaust Kitchen Hood/Duct Hazardous Material (Tier If or RQ Facility) ANNUAL •
<br /> 1 . • Controlled Bum I Hood Installation
<br /> I Emergency Generator < 30 kw I LP/Natural Gas-Installation
<br /> . `.* • . .1. . Emergency Generator > 30 •kw 1 LP/Natural Gas-ANNUAL Sale
<br /> Fire Protection Maintenance - ANNUAL ' • 1 Places of Assembly-ANNUAL
<br /> luttrly( !Semi ( 1Ani 1 gam
<br /> -........, - . . Sprinkler , 1 o 0 o • I Recreational Burn .
<br /> ,• • , - , Fire Alarm , - 1j ° 0 r • • ' 1 Sparklers
<br /> , • Hood Cleaning 1 ° 0 0 1 ' 1 1 Sprinkler System Installatiohg
<br /> Hood Suppression - 1 1 0 0 1:3 1 . _1 I 1 ..StarldPiPes (Sprinkler Sys) . ... ...
<br /> - - - ....-.,,r-'-. F71.• --- Firerrn Installation - • ' :-: ' " • ' - - ". • - — — - 1 f - Torah Rcioffpg/Tar Kattle '-", • --. ' 'i'• - .--. - - •• - •
<br /> -.: • ,•,..... t i. • •., 1..• Fire Pumps • 1 • • . Waste Tire Storage ANNUAL
<br /> • ...if,„•1:.:,, 1 - Fire Works • , •
<br /> • , . •
<br /> • .1., 1:::: I. :, Flammable Application- ANNUAL , . I .
<br /> - :1 Valuation of Project
<br /> Fuel ' ' ' ' - ' . ' - . - . - • - ' . ' . . : .
<br /> • ' 1 • • 1 Other: 1 . • . • •
<br /> 4sexisagessuessanzassim
<br /> Contractor ' • i 41111r
<br /> . . • • Company " Ce
<br /> Signature • • Reg N istered Y / Fee Current 1% Y / N 1 •
<br /> / -
<br /> ELECTRICIAN --, • ; '1? ‘,-.7 -..• •,.. . . . ..., • :.-.: • : .. - - 2 -• ; - - Company . -* . -- , - -..;.. . ., - ..-; - , t • -. , . ' ,
<br /> Signature - • ' ---•• -. ' - . ''' - ,.. . - : ' '' ' .. • : -. , Registered •-- -• Y / N 1, .:,..Fee.,Currqrtt.t. 1 , Y / N
<br /> - s • ' • -:
<br /> Address 1 - , I License # - , , ' . . ', , • ' • - '-'•'' I , ,
<br /> •
<br /> PLUMBER .. Company ••• • , -,.„.;,•• • . . .. 7 s . ,,,,, .• ,7 . -.
<br /> Signature - .
<br /> Registered Y I N I '1 Fee Cun 1 Y i N7 1- • ' •
<br /> Address 1 , .
<br /> . • 1 License # . * •
<br /> MECHANICAL - Company •
<br /> Signature . . Registered Y / N 1 Fee Current 1 Y / N j
<br /> . Address ,. .... • - 1 License #. 1
<br /> OTHER • • Company . . .
<br /> Signature • Registered Y/NI Fee Current 1 Y / N
<br /> Address . License #
<br /> Directions: • _ . -
<br /> -
<br /> • Fill out application completely.
<br /> . Owner & Contractorsign back of application, notarized (Or, copy of signed contract with owner) • .
<br /> If over $2500, a Notice of Commencement is required.(Mec,hanical work over $5000) .
<br /> - -T: . • ,-, , . . - Supply two (2) sets af drawings with applicable documentation -. -
<br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com)
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<br /> ,-.-•-:.- 7 _ = - - .
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