Laserfiche WebLink
31? - 7 �0-�J�i2� �'.I�i)/ Of Z ephyrhills F'If� raf-o �o-r ov-wc � <br /> Permit Application _ - <br /> Dats R�cpived � � _ - - �--� <br /> Phone Con;act for Fermit (cLl <br /> .�.,.w_:_ �;.<.:. ;.x;...�.�.�.,.�:..,.:.....�.,....- • s��sa� - -- r__�_....�.. _r. <br /> a�3 3 , <br /> : �:��:w,.,-�.�_"�.:.a;- � . _ . _ . ._._ _.�:.._ _ �.._ _�.,�..s,.� . ,.:- :. ..�..: <br /> Own=r's Nam� LQ(L! C� (� 1 �.j �G Owners Phone Number ( 3 �� � µ� <br /> Own°t's Addrsss �jpj � 3� �'�11�..�G.C.fi � tJ�R-ls Z.(�Q� 2�'E't�1-S ,��L 3� s°1�0 <br /> Fee Simple Titl=holder Name Titieholder Phone Number �� �� � <br /> F>e SimplaTitlsfiolderAddress <br /> �.�x+��. ��^ .�'i��'�..�.T•!"-��,a`�� P"c.z'���'��ar-'�.'y� � r='+�T�s <br /> Job Address 3�7 � 3j 1�l �+ZK-C�� '��.dR'�% Ix' zL�l'��-1�'lu''S Lot� �� <br /> 5ub Division � l� �(i'p/� kILLS Paroel � Z ' 7(0 - L) � � (� ' ��� '� <br /> �r�.s�t:�„� <br /> � Bio-HazarJ Wasta Storege -ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen HoodlDuct � Hazartious Material (Tier II or RQ Facility) ANNUAL <br /> a Controlied Bum � Hood installation <br /> � Emergency Generator < 30 kw � LPlNatura! Gas-Instaliation <br /> � Emeraency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance -ANNUAL � Places of Assembly-ANMUAL j <br /> tr y ami On ar � I��, � <br /> Sprinkler � ❑ ❑ B � Recreatioral Bum � <br /> Fire Alarm ❑ ❑ ❑ � � Sparkl=rs <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System fnstaltations �� <br /> Hood Suppression � � ❑ O� � Standpipes (Sprinkler Sys) ( 11 � <br /> � (/ <br /> � Rre Alartn InstailaUon a Torch RoofingfTar Kettle <br /> Fire Pumps � Waste Tire Storege ANNUAL <br /> Fire Works <br /> FlammabieAppfication-ANNUAL ��',p�j Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> r,�.�,� ..� -- <br /> ConVactor Company <br /> Signature Regist�red Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature Reglstered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y! N Fee Current Y/ N <br /> Address License # <br /> OTHER TL.�2- � Company (Zpp/k� FJ2L �17� k1Y.�ZS Jl�k... <br /> Signatu2 Registered � N Fee Current �� N r <br /> Address ZrjZ7 l ./1 -� . �C., . 3� I �icense � 43 ��° 7�C� 11 °1�i <br /> w . . . , .,.,;;...�.._.:>._.�. _. . . _. - --� ..,_.��..�....,.�..,...3.�..TU �,..��. <br /> --e..,�:_..._-._-�. . __�_° .__ _ ._...�., - .� __ <br /> Directions: '�� <br /> Fili out application completely. <br /> Owner 8 Con;ractor sign 6ack of application, notarized (Or, copy of signed cont2ct with owner) <br /> If over 52500, a Notice of Commancement !s required (Mechanical work over �5000) <br /> Suoply two (2) sets of dawings with applicabla documen;ation <br /> Allow 10-14 days for review after submi;tal date. Par�ei r- obtained from Property Tax No;ice (http:/Iap�ra?ser.pascogov.com) <br />