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a��-�eo-oo2o City ofZephyfiillsFirs, FaX-a�3-�so-oo2� _ <br /> Permit Application - _ - <br /> Date Received Ptwne cor�act for Pennit - <br /> Owners Name � Owners Phone Number �[_�� �� Z�� 1 <br /> Owners Address 3 11�� � �� l � <br /> Fee Simple Titleholder Name � � �� �� �� � <br /> Fee Simple"fitleholder Address <br /> Job Address Lot # � <br /> Sub Divisfon ��� # <br /> � Bio-Hazard Waste Storage - ANNUAL Q Fumigation TeM <br /> Q �� �� K .�� �� Q Flazardous Matsrial (Tfer II or RQ Facility) ANNUAL <br /> � ControNed Bum � Hood Installatlo� <br /> � ��, � < 30 � � LP/Nat�xal Gas-Insfailation <br /> � Emer9encY Ge�erator> 30 kw � LPMahaal Gas-ANNUAL Sals � <br /> Q Ftrs Protection Mai�ance - ANNUAL � Plac�s of Assembly-ANNUAL <br /> � �� � <br /> Sprinkter � ❑ � ❑ �� � Re�reationai Bum � � <br /> Fire Alarm �❑ ❑ ❑ S�� J�' I� <br /> Hoad Geaning � ❑ ❑� � Sprit�icler System Instailations �� � <br /> Hood S�pression � � ❑ ❑�� � S� � S <br /> � �� �� �� a Toroh Roofingffar Kettle <br /> �� P � � Waste Tue Stiorege ANNUAL <br /> Fine Works <br /> ��� �;��� q�,q,��q� Valuation of Project <br /> Fuel Tanks <br /> er. <br /> Contractor � • ��Y <br /> 5 ��� Registe�ed Y/ N Fee curr�rc Y/ N <br /> Address '� LiCense # <br /> ELECTRIC CO �m - <br /> Si9natwe Fteytstered Y/ N Fee C�.arent Y/ N <br /> Address Licxnse # <br /> PLUMBER � - - — <br /> �ignati,re � _ � � Y! N .�!�r�8'�'� L , Y� 1N <br /> Add�ess License # � <br /> MECHANICAL ���Y <br /> 5� Rey;ste�ea Y/ N Fee current Y/ N <br /> p�� License # <br /> oTM� ��"�' <br /> 5 � 9 � Rey;s�d Y/ N Fee cuRent Y/ N <br /> q�� License # <br /> Ditections: <br /> Fiil out application car�letety. <br /> Owner & CoMractor sign back of aippliqtlon. rwtaraed (Or. copy of signed contract wifh owner) <br /> If over 52500. a NoUce oF C,orrmers�mant is re4uired.(Mec�anical work over 5500U) <br /> S,�,py two (2) sets oF drawin9s with appGcawe doc�ane�Son <br /> Allow 10-14 days tor review after subrrrottal dabe. Parcel #- obtained from PropeRy Tax Notice (httP��PPraiser.pascogov.com) <br />