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JUL /13 /2008 /SUN 04:13 PM ZEPHYAHILLS BUILDING FAX No. 813 P.002 <br /> C ofzephyrhillFi <br /> ste•- 5 Fax -813. 780 -0021 <br /> n13-780-0020 � � � 1 1 <br /> Permit Application - - <br /> Date Received :Phone .Contect for Permit 2 3 3 br t® 3rd 2 - • <br /> -�� -. .... _.. _..... <br /> Owner's Name, .I i o t - si Gn4•i.Z li, c r +� 3 ,1. .2. 1 Owner's Phone Number 1 � t 1. 117 cY; 1 I '1 u 3 2 .I <br /> Owner's Address • L b I S l j 2+'t i 2k y.. - h'i 11.5 , FL `.3 3 9 0 . I <br /> • <br /> Fee Simple TiUeholder Name • ( • • 1 Titleholder Phone Number 1 . 1 1 1 1 I <br /> Fee Simple1fUeholder Address 1 i-- .� <br /> Job Address I lv S t Z tL S► Z� '1 r Yt t l S FL_ 3 35'11 ------ Lot # 1 1 <br /> 1 • •I' I • 1 <br /> Sub Division _. . <br /> Parcel <br /> • <br /> n Bio- Hazard Waste Storage -.ANNUAL •' p Fumigation Tent • <br /> 0 , Comm Exhaust Kitchen Hood/Duct Hazardous Material (Tier 11 or RQ Facility) ANNUAL .. <br /> a Controlled Burn. ' ' 1 Hood•Inatefatlon • <br /> • Q Emergency Generator•< 30 kw • LPMatural Gas - Installation <br /> . 3 •Emergency Oenerator> 6o kw J . • .. . ' Q LP /Natural Gas - ANNUAL Sale • <br /> ED Fire Protection Maintenance - ANNUAL • 173 Places of Assembly- ANNUAL . <br /> L"irF4 is ull � L'uL3i • <br /> Sprinkler E3 O 0 .0 a Recreational Burn, . , <br /> Piro Alarm ' 13 O D IJ • = Sparklers • <br /> • Hood Cleaning 0 O 0 = Sprinkler'System Installations <br /> • Hood Suppression 0 0 . .0 0 El Standpipes (Sprinkler Sys) • • • • a Fire Alarm Installation Torah Roofing/Tar Keale • <br /> R . Fire Pumps • . • • • • • . =I Waste Tire Storage ANNUAL .. • • • • <br /> Fire Works • • . ' <br /> FR Flammable Application- ANNUAL .I • • •1 Valuation of Project <br /> Fuel Tanks <br /> Q Other. 1 <br /> Contractor —+` Company 1 th - ' CY\ . 'n'-tr <br /> Signature .. Cam'- 'f'utl— ( A '°it �'� �. Registered t4 Fee current / N • <br /> J <br /> Address ( 1..., L t_% 2- 3z ;n j �Yn' v. ? " 7c w.... L - ' 3 I L.3 y 1. -_ ucense #...J t3 F 2- VCOU 33 1 . ._ <br /> ELECTRICIAN • ' 0 Company 1 • <br /> Signature . Registered I Y / N 1 Fee Current 1 Y / N 1 • <br /> Address I • j , , License # 1 <br /> PLUMBER . . • • • • Company I 1 <br /> Signature I • • ' ' • Registered Y / N Fee Current 1 Y / N . <br /> Address ( • 1 License # I 1 . • • 1 <br /> • <br /> MECHANICAL Company . '1 <br /> Signature 0 Registered I Y/ N 1 Fee Current 3 Y• / N J' 0 <br /> Address I • •] Lltenae # . <br /> OTHER • ' . . . . . Company <br /> Signature Registered I Y/ N J Fee Current 1 Y/ N I <br /> .Address • • License # . <br /> 'ructions: • <br /> • Fill out application completely. • • <br /> Owner & Contractor sign back of application, notarized (Or. copy of (Hgned contract with owner) • <br /> If over 132600. a Notice of Commencement 10 requlred.(Mechanlcal work over $6000) • <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. /appreieer.paseogov.com) <br /> RECEIVED 07- 13 -'09 15:56 FROM- '8137800021 TO- 0 Devcon Security P002/002 <br />