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MAR /28/2007/WED 07:20 AM ZEPHYRHILLS BUILDING FAX No. 813 R. 001 <br /> 813- 7s0 -002o City of Zephyrhllls'Pllie: -• Fax- ale-no -Dorm I; <br /> ,� <br /> Permit Application ay. <br /> • <br /> Date Received • 'rm./gar ✓ .Phone r Permit 1 2b 1 <br /> Owners Name ( /1 � ` 1 _ Owns?* Phone Number $t�� �� [Mr <br /> Owne? 18 o Address $ l >CJtll d f�Y t � 1t �� 1 PL 3,3,9-11 <br /> - • <br /> Fee Simple Titleholder Name • • - Titleholder Phone Number [ 1 I. <br /> Fee Simple Titleholder Mdress 1 • • <br /> Job Address <br /> 1 3 8 \ B 1 v d t 7 t e c en kills A F L Lol# - <br /> Sub Division , U Parcel # J <br /> .: El Comm Exhaust Kitchen Hood/DUCt� Hazard .• <br /> I I Fumigation Tent <br /> Hazardous Material rer 1I or RQ Facility) ANNUAL • - / ) <br /> Controlled Bum Hood Installation / l� 3 ,([ // <br /> 0 Emergency • Generator < 30 kw n LPINaturel Gas - Installation ' / - J � ' / <br /> •.n 'Emergency Generator> 30 kw -- . 17 LPMatuml Gas - ANNUAL Sale • <br /> I >l Fire Protection Maintenance : ANNUAL . n Places of AssemblyANNUAL \, , <br /> MO EZEI 11 PST <br /> Sprinkler p ❑ Rsoretltlonal aunt <br /> T Fire Alarm . Q. ❑ -) I ED Sparklers 1 ^ � <br /> 5 i•r f� <br /> Hood Cleaning n c . ❑ p [ I FR Sprinider'Syatem Instafations • `�/t •1 � I d ieA 4 <br /> Hood Suppression ❑ p (Sprinkler Sys) � <br /> n Firs Alarm kiatasation Torch Roormg/Tar Kettle • <br /> Fire Pumps . • 0 1 Waists Tiro Storage ANNUAL t I �� 15110 <br /> • <br /> g Firo Works • • •. <br /> • <br /> Flammable Application- ANNUAL ) •1 • Valuation of Project <br /> Fuel Tanks <br /> • Q • Other: - . • <br /> contractor V �) Cr.✓ 6r,� -- �mp�Y • t 1YOr1 . =g <br /> r, � eg :•. -• <br /> , ... <br /> Signature V w1�� It��1 Registered Fee Current <br /> Address L altars i - . .MR__U s1111 . ... : 1 License j 9 9 66q nOO,2O, a 1 <br /> ELECTRICIAN) -'t - ID company ' <br /> Signature <br /> Registered Y / N Fee currant 1 YIN <br /> Address I j License # I • I <br /> • <br /> PLUMBER . • Company 1 • <br /> Signature Registered Y/ N 1 Fee Current 1 Y/ N 1 <br /> Address I License # <br /> • <br /> MECHANICAL I Company 1 <br /> Signature Registered Y/ N 1 Fee Current 1 Y/ N 1 I <br /> Address I • I • License # . - 1 <br /> - <br /> OTHER Company I <br /> signature Registered • Y/ N 1 Fee Current I Y/ N I <br /> Address __ • License* <br /> Directions: <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 requlred.(Mechanical work over $5000) <br /> Supply two (2) seta of drawings with applicable documentation . <br /> Allow 1044 days for review after submittal date. Parcel it obtained from Property Tax Notice (http / /appreiaer.pascogov.com) • <br /> • <br /> • <br />