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City ofZephyrhillsFir�� Fax-e�s-�saoo2� : <br /> a�; �ao-oo2o Permit Application - --- <br /> Phone Co�rtact for Permit � <br /> Date Received <br /> Owners Phone Number . � �� 7.5� � <br /> ow�rs r��►,e . <br /> owr,er5 Ada� � �ie�U � uc.Q • l - �'" <br /> Titlehoider Pho�e Number �� � � <br /> Fee Simple Titleholder Name <br /> Fee Simple TlUeholder Address ` " =—� <br /> Lot # <br /> u <br /> Job Address <br /> Parcei # <br /> Sub Divisfon <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigatlon Tent <br /> a Hazardous Material Rer il or RQ Facility) ANNUAL <br /> Comm Exhaust Kitchen HoodlDucc � <br /> � Controlled Bum Hood Installation <br /> � Emergency GeneraWr < 30 kw � LPtNahual Gas-Installation <br /> � Emergency Generator> 30 kw Q LPMaturdl Gas-ANNUAL Sale -- <br /> � Fire Protection Mairrtenar�e - ANNUAL � Places of AssemblY-ANNUAL <br /> ���� � <br /> Sprinkier � ❑ O ❑ Rec.�eational Bum � �� <br /> ❑ � � Sparlders .j # i j 2 <br /> Fire Alartn ❑ ❑ ❑ �� <br /> Hood Cleaning �. � ❑ Sprinkler System Installatians <br /> Hood Su ression ❑ ❑ ❑ C� � S��pipes (Sprinkier Sys) <br /> Pp � <br /> � Fre Alartn Installatlon a T°rc.h R°°fi�9�Tar Kettle <br /> Fre Pumps � Waste Tira Storage AHNUAL <br /> Fire Works �� <br /> Flammable Application- ANNUAL Valuation of Project <br /> Fuei Tanks <br /> er: <br /> Contractor . Company <br /> Sj9n ` Registered Y/ N Fee Current Y 1 N <br /> Address '� License # <br /> ELECTRIClA �� <br /> Signatura Registered Y/ N Fee Currerrt Y/ N <br /> Address License # <br /> PLUMBER � CO �� Y <br /> Signahxe Registered Y/ N Fee Current Y/ N <br /> Address � _ . __ — Lieense # ( <br /> MECHANICAL � <br /> S'g ��� Registered Y/ N Fee Current Y/ N <br /> Address �� # <br /> OTHER �� <br /> signature Registered Y/ N Fee Currerrt Y/ N <br /> Address �� # <br /> Directions: <br /> Fill out epplicatlon completelY. <br /> Owner 8 Corrtrector sign back of application, rwtarized (Or, coPy of sig^ed �°^tract w�h °�r) <br /> tf over $2500, e Notice of Commencement is required (Mechanical work over $5000) <br /> Supply two (2) sets of drawings with appticable doc�une�tation <br /> Allow 10-14 days for review aRer submittal date. Pat�el #- obtained from PropeRy Tax Notice (httP��aPP��.P�Ogov.com} <br />