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a��-7a= �02o City of Zephyrhills�Fir��� Fax-a�a-�ao-oaz� <br /> Pertnit Application ' <br /> )ate Received � - Phone Contact for Permit � T � <br /> :��:s���-r.�:n::��c�;;��:>a a...<..�,..��:� ��:�+a+aa.�e.���� �snr� �..,..,....�.....,...,.�. . .,... _...__�_ <br /> hvners Name �' � , � /� � �� Ovmer's Phone Number C;�L�.L.—J �.S�J <br /> �wners Address �j ,� ���- \ � �i � e. i ,� � I � � � ' <br /> =ee Simple TiUeholder Name Titleholder Phone Number �� �� <br /> =ee Simple Titleholder Address <br /> �''xi.."s � - �a. ��i�F <br /> Job Address �� � yy. '� Lot # � <br /> 5ub Division Parcel # <br /> '�'�'ha�i�+ •! 1 �l��iJ+'%Y�'�'�7a.f <br /> a Bio-Hazard Waste 5torage - ANNUAL � Fumigallon Tent <br /> � Comm Exhaust FGtchen HoodlDuct � Hazardous Material (Tier II �r RQ Facility} ANNUAL <br /> � ConVol{ed Bum � Hood Installadon <br /> � Emergency Generator < 30 kw � LP/NatureY Gas-Installation <br /> Emergency Generator> 30 kw a LPlNatural Gas-ANNUAL 5ale <br /> Fire Protection MaiMenance -ANNUAL � Places of Assembly-ANNUAL <br /> �y emi �"7n ' er <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum n �� <br /> Rre Alartn O ❑ �`] � � Sparklers �� � <br /> Hood Cleaning � ❑ p /❑ � � Sprinkler System installatlons � <br /> Hood Suppression �❑ p O�� � Standpipes (Sprinkler 5ys) <br /> Q Fire Alartn Instaliation � Torch RoofinglTar KetUe <br /> Fire Pumps � Wasts Tire 5torage ANNUAL <br /> Fire Works � <br /> Flammable Application-ANNUAL r��� Valuation of Project <br /> Fuef Tanks <br /> � Other: <br /> �� ����� <br /> Contractor - <br /> Comparry _.,'�ertl �.��.�_�"�anw �t <br /> Signature ' Regiffiered Y N • Fee Current N <br /> Address � � \ � �] - '� - � � , c . ' - License # 4 j i5 • v <br /> ELECTRICIAN Campany � <br /> 5lgnature Registered Y/ N Fee Curtent Y/ 1� <br /> Address License # <br /> PLUMBER Company <br /> 5ignature Registered Y/ N Fee Current Y/ N <br /> Address Licensa # <br /> MECHANICAL Company <br /> Signature Registered Y I N Fee Current Y/ N <br /> Address License # <br /> OTHER <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> T',lw�'i • . x�x,ez..,.._...�d_a+arwaa,z-����irw_ _.,��_,-....,...,�..._..�aa.w�s.a..,.,�..is3�lf�mn>au�a,�ettkn� .:-,�b.E:_:�'; <br /> Directions: —�:-�-°°°-i5 <br /> Fill out applicatlon completaly. <br /> Owner 8 Contractor sign back of appiiptior�, notarized (Or, copy of stgnad contrect with owner) <br /> If nver 5250D, a Notice of Commencement is required {Mechanica! work over 35000) <br /> Suppiy two (2) sets af drawings with applicabie dacumentatio� <br /> Allaw 10-14 days for review after suhmittal date. Parcet #- obtained from Property Tax Notice (http:/lappraiser.pascogov.00m) <br />