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813 City ofZephyrhillsFirs� F�-e�a-�so-oo2� _ <br /> Permit Appiication _ _. _. <br /> Date Received Ptrone Contact for Pertnit <br /> Owners Name � Owners Phone Numb� r � � �` <br /> Owners Address '� 2 �J� �, , l� � � <br /> Fee Simple'fitleholder Name Titleholder Phone Number ��� <br /> Fee SimpleTiUeholder Address <br /> Job Address Lot # � <br /> Sub Division ��� # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> a Comm Exhaust Kitchen Hood/Duct a Nazardous Material �er II or RQ Faciiity) ANNUAL <br /> � Controlled Bum � Hood Instaliation <br /> � Emergency Ge�erator < 30 kw � LP11Varival Gas-Installatlon <br /> Q Emergency Generator > 30 kw � LPlNatural Gas-ANNUAL Safe <br /> Q Rr� Protection Mairrtenance - ANNUAI � Places of Assembly-ANNUAL �(_ --- <br /> �y em � r /7 � � <br /> � v� <br /> Sprinkler � ❑ O O � Recreational Bum <br /> Fire Alartn � ❑ O ❑ � � Sparlders <br /> Hood Cleaning ❑ � ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Sta�dpipes (Sprinkler Sys) <br /> � Fire Alartn tnstallation a Toroh Roofinglfar Kettle <br /> F�� p�p� � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Appiication- ANNUAL r Valuation of Project <br /> Fuel 7a�ks <br /> er. <br /> Contrdctor � � � CompanY <br /> sig�awre Registered Y/ N Fee Current Y/ N <br /> Address � '- License # <br /> ELECTRICIA Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER ���y <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address u� # <br /> MECHANICAL Comparry <br /> si9nature �eyistered Y/ N Fee CurreM Y/ N <br /> Address License # <br /> OTfiER Compa�y <br /> Signature Reyisterad Y/ N F� Cument Y/ N <br /> Address License # <br /> Direc6ons: --- - --- - <br /> Ftll out applicadon completefy. <br /> Owner & Contractor sign back of applicatlon. notar¢ed (Or. coPY aF signed contract wffh owner) <br /> If over 52500. a Noti� of Cortunencert►errt is req�dred (Machanical work over 55000) <br /> s�pir two (2) s.ts ot driwirx,�s wia, apQllcable docun,enmLon <br /> Allow 10-14 days for review after submittal date. Parcei #- obtained from PropeAy Tax Notice (htlpJlappraiser.pascogov.com) <br />