Laserfiche WebLink
31?-7E0-�^i�'7 C(�f Of Z �phyrhills F11'2 ran� �.�-, o�- yv�i - <br /> Permit Applica±ion , G^ (,�,��yr�5 - <br /> � ��I <br /> Dats Received Phone Con;act for P rtnit �� ? j �� <br /> : �:�a�:�.:�r.c�-.:�.-...�.;.<_:ti-._�...�......>_..,:...,_�..�.._ ,���,.���x����.����cixzz� v- ._,_ . _ _.t.._ <br /> Ownsr's Name � � uN � C� Owners Phone Number g� � ��Sl°�' ��rTl7 <br /> Owner'sAddress�� 3�'��5 T SQ�va+2� 1Z1-�I I S �- �S� <br /> Tee Simple Titleholder Name Titlehol�er Phone Number �� � <br /> F�e SimplaTitisholder Address <br /> ��i�"'�� - .^-:�.t '"' =.�"`-a�s:w�:�s.�::5i::�::-�'�i� <br /> JobAddress �� 11f�1�. � Lot# � <br /> Sub Division C � T ��i,, S Paroel # G. " 2�o ' �' tJ" V � �' Q7� <br /> t �.-� �„ •...sx.-.tr�"'�� <br /> � Bio-Hazard Waste Storage -ANNUAL � FumigationTent <br /> Q Co:nm Exhaust Kitchen HoodlDuct � Hazartious Material (Tier II or RQ Faciiiry) ANNUAL <br /> � Controlled Bum a Hood Instaliation <br /> � Emergency Generator < 30 kw a LPlNatural Gas-Installation <br /> � Emergency Generetor> 30 kw � LP/Natural Gas-ANNUAL Sale <br /> a Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL /y �/} <br /> tr y emi �n ar J[/ / l.� 7 <br /> Sprinkler � � ❑ ❑ B � Recreational Bum -{� J ( � <br /> �� <br /> Fire Alartn � ❑ O O� S <br /> Hood Cleaning � ❑ ❑ ❑ SprinklerSystem instalfations <br /> Hood Suppression � � ❑ O nn er Sys) <br /> � Firs Alarm Installafion � Toroh Roofing/Tar Kettle <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> F7ammable Appfication-ANNUAL � q �'ja 00 Valuation of Project <br /> Fuel Tanks <br /> Q Other: O I N � s <br /> �� <br /> Contractor Company <br /> Signature Regist�red Y/ N Fee Current Y/ N <br /> Address Licertse # <br /> ELECTRICfAN Company <br /> Signature Registered Y! N Fee Current Y/ N <br /> Address License #� <br /> PLUMHER Company <br /> Signature Registered Y/ N Fee Current �' / N <br /> Address License � <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHcR �Q1,) '�; Qd(,J Company (�. <br /> Signature Registered / N Fee Current / N <br /> Address - Q � ( 9 g <br /> ; ,; ti.._ _ .. --�- �- - �-�--�= _.. - - -e,,.._-:.__� ._ �:-��.�.,....: . ._:........�_.�. • - -<..«.�._� -,......,.......,_-_..,...s.�.�.�....� -<,u—���-,,� <br /> License ,� <br /> .�as_,�_.�..¢ ,�.�..� _ _.. _. _ ..�R,. <br /> Directior.s: <br /> FII out application completely. <br /> Owner � Con;ractor sign back of application, no;ariz=d (Or, copy of signed contrect with owner) <br /> lf over 52500, a Notice of Commsncement is required (Mechanical woric over 55000) <br /> Supnly two (2) s=ts of dawings with appficable documen,ation <br /> Allow 10-14 days for review after submittat date. Paroel r- obtained from Property Tax No;i�e (http:/Iap��iser.?ascogov.com) <br />