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s�3-�ao-oo2o City ofZephyrhillsFi�:- _•. Fax-sisaso-oo2� <br /> ` ?emtit App(ication <br /> Date Received -' Phone Cordactfor Pertnit <br /> , O�mer'sName bt� �b1 � �S1Q .�S Ownet'sPhoaeNumber � � � <br /> OwnersAddress 38c�ao h.Vt11' 1�-Q�r11�� ` �'1 1�� F� 3��'a� <br /> Fee SimpleTiUeholder t�tame Tideholder Phrone Numbe� C] �� <br /> Fee Simple'titleholder Addrsss <br /> Job Address Lot# C <br /> Sub Dirision Pa�el # <br /> � Bio-Fiazarcl Waste Storage -�ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kltchen HoodJDuct • ����� ��I (Tier II or RQ Facility) ANNUAL <br /> a Co�olled Bum � Nood Ir�taiMatlon <br /> � Emergency Ge�rator < 30 kw � LPMatural Gas-Insiallafion <br /> � Emergency Generator> 3U kw � LP/Natu21 Gas-ANNUAL Saie <br /> � Fire Protection MainGenance - ANNUAL Q p�� °� ����� <br /> � emi �n er <br /> 5prinkler � ❑ ❑ ❑ Recreational Bum <br /> Frs Alartn � ❑ ❑ O C� � �5patlders <br /> Hood Cleaning � D ❑ ❑ C� � Sp�inklerSystem Instaliations <br /> Hood Suppression � ❑ 0 O�� ���PiP� (Sprinkler Sys) <br /> � Fire Aiartn Installatlon � Torch RootinglTar Kattle <br /> �� P � Weste lite Storage ANNUAL <br /> Fre Works <br /> Flammable Application- ANNUAL Valuation of Project <br /> FuelTanks <br /> � Other. <br /> � <br /> cor�oco� � , , ��m <br /> Signature Reyistered Y/ N Fee Current Y/ N <br /> Address l.icense # <br /> ELECTRICIAN � COmparn - <br /> Signature Registered Y I N Fea C.tirrerrt Y/ N <br /> Address , Lie:ense # <br /> PLUMBER COm�^Y <br /> s� Reyistered _ Y/ N� Fee CuRern Y/ N <br /> Address ' license # <br /> MECtiANICAL Company <br /> signature � Registered Y/ N Fee Currerrt Y/ N <br /> Address License # <br /> OTHER �p� <br /> signature Registe�nd Y/ N• Fae Gurrant Y/ N <br /> Address License # <br /> Directioru: � <br /> FiU out appfleation eompletefy. <br /> Owner & Coritrador sign back of application. mtar¢ed (Or. copy af signed contraet with owner} <br /> Ifi over 52500. a Notice of Cort�mencemerrt is required.(Mechardcal work over 55000) <br /> suaplr two (2) sata af arawira�s wla, appiicable da«,mer�n <br /> Ailow '1 Q14 days for review aRer subrt�tal date. Paroel #- obtained from Properiy Tax Notice (fitlpJlapprai�.pascogov.com) <br />