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si 3aeo-oozo City ofZephyrhillsFir�-: -�. •�.. �� Fax-a�saso-ooz� <br /> Pertnit Application <br /> Date Received ,- Pfmrie ConfactforPermft <br /> :� <br /> dwner's Name 1�t� � b 1�. E/(�L .� S Dwnet's Phone Number F5 �� /� oc � 1 � <br /> Owners Address ���, � 1�t� 11 `J 1 t1 V�l1 U..Q_. " �1 1' f i� F� �J 3Jy'a� <br /> Fee Simpia"titleholder Neme Titleholder Phone Number � C] � <br /> Fee Simple?itleholder Address <br /> '� �A a��s5 �c��� �r� P�, %� 33S4a �v � s�QE� r+ �o° �� <br /> 5ub Division Parael # <br /> � Bio-Hazard Waste 5torage -�ANNUAL o Fumigatlon Tent <br /> � Comm Fxhaust I�tchen HaodlDuct • � Naiardous Material (7ier 11 or RQ Facifity) ANNUAL <br /> � Controlied Bum a Hood InsiailaUon <br /> � Emerganay Generator < 30 kw � LP1Natural Gas-Insiall88on <br /> � Emergency Generator> 30 kw � LPfNatutal Gas-ANNUAL 5afe <br /> Fire Protecbon Poiairrtenance - APINUAL Q Places of Assembiy-ANNUAL �,?j �� <br /> �0� � � <br /> 5prinider n ❑ ❑ p� � Rscreational Bum <br /> Fire Alarm � O ❑ ❑ � � �5pariders <br /> Hood Cleaning � ❑ p p� � Sprinlder5yst�m Irstaliations <br /> Hoad Suppression � p ❑ p� � Standpipes (Sprinkler Sys) <br /> � Fre Alartn InstailaUon � Torch Roaflng/Tar Kattla <br /> Fre Pumps � Waste Tire Storage ANNUAL <br /> Fite Works <br /> Flammable Applica6on-ANNUAL Valuafion of Project <br /> Fuel Tanks <br /> Q Other: <br /> Contractor A i �pmPa <br /> Sigriature �4 R�istered Y! N Fee Current Y/ N <br /> Address � V�� # <br /> ELECTRiC1AN " � ��� <br /> Si9�� Registered Y/ N Fee Cument Y/ N <br /> Add2ss License # <br /> PLUMBER ��� <br /> Signature Reyistered Y/ N• Fee Cument Y/ N <br /> Address ' License # <br /> MECNANIC � — <br /> S�9� Rcyistered Y/ N Fee currern Y/ N <br /> Address LicensQ # <br /> OTHER � <br /> Sig�ature • Registered Y/ N. Foe Currerrt Y! N <br /> Addiess / License # <br /> _ _ _--- <br /> D�rections. – <br /> Fil out applieation completely. <br /> Owner & Coritractar sign badc of aPPUcaUon. nofari¢ed (Or. eopy of signed conbact wRh rnmer) <br /> if o�r $2500, a Alotice ot Cortunencemerrt is required.(Mechanical vwork over 55000) <br /> S�PP�Y two (2) sets of drawings with appllcable docume�tion <br /> Aliow 10-�4 days for review after submttta! date. Par�et #- obtained fmm Pcopecty Tax Notice {httpJ/appraiser.paseogov.com) <br />