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a�3-��Cwozo City ofZephyrhillsFir�� Fax-s13-780-0021 _ <br /> Permit Application � -�-� <br /> Phone Conhact for Perrnit <br /> Date Received <br /> Owners Pho�e Number . !� 7�� r 22� <br /> Owners Name � _ <br /> Owners Address �$ �'i u �• v�W 1 •` + � 2 • - l` ' � <br /> Fee Simple Titlehdder Name Titleholde� P�w�e N��r �� C� <br /> Fee Simple TiGeholder Address = <br /> Lot # � <br /> Job Address <br /> Par�el # <br /> Sub Divislon <br /> � Bio-Hazard Waste Staage - ANNUAL a Fumigatian Tent <br /> � Comm Fxhaust Kitchen FbodlDuct � �-�az�rdo�S Material (fier 11 or RQ Facility) ANNUAL <br /> � ConUolled Bum � liood Instailation <br /> a Emergency Generator < 30 kw a LPMatural Gas-Instal{aUon � <br /> o Emerger�y Generator> 30 kw � LP/NaWral Gas-ANNUAL Sale �,� — <br /> Q � Places of Assembiy ANNUAL / yl � v <br /> Fre Protection Maintenance - ANNUAL i• y <br /> � � �� � � <br /> Sprinider � ❑ ❑ ❑ Recreational Bum <br /> Fire Alartn �❑ O D C� � SPa►�rs <br /> Hood Cleani�g ❑ r �� � SPn�r System Installations <br /> Hood Suppression �❑ 0 O StarxiPiPes (Sprir�Cler Sys} <br /> � Ftre Alartn lnstallation � Torch Roofingffar Kettle <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Fl ��� B �� � Valuation of Project <br /> Fuei Tanks <br /> r. <br /> Coritractor � � . Company <br /> 5 ���� Reg;scered Y/ N Fee curreM Y/ N <br /> Address ''� License # <br /> ELECTRICIA CO <br /> signature Resistered Y/ N Fee Currern Y/ N <br /> Address U0 � # <br /> PLUMBER CO <br /> siynaame Resis�ered Y/ N Fee Current Y/ N <br /> Address ucense # <br /> MECHANICAL COT �� <br /> stgnawre Registered Y/ N Fee currern Y 1 N <br /> Address ���� # <br /> OTHER �rn <br /> Si9 ��� Registered Y/ N Fee Curtent Y/ N <br /> �� License # <br /> Directfons: <br /> Fiil out applicadon completefy. <br /> Owner & Contractor sign back of applicatio�. notarized (Or. c�Y of signed contract with owner) <br /> If over 52500. a Notice of Commencemerrt is requirad (Mechanical work over �5000) <br /> Supply two (2) sets of d�awi�gs with applicable docur►errtatlon <br /> Allow 10-14 days for review after s�mittal date. Pareel #- obtained from Property Ta�c Notice (hCp:Uappraiser.pascogov.com} <br />