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a�3-78o-oozo City ofZephyrhillsFir�� Fax-a�saso-oo2� : <br /> Permit Application _-- <br /> Date Received P�� ��t �� �� <br /> �.��.:�K. ,�. <br /> Ownet's Name � •� Owners Phone Number L '� J�� !U !�t'� <br /> oNmers Ada�ss g 3 l.l 1 ��� �� <br /> Fee Simple TiUeholder Name Titleholder Phone Number � L�! � <br /> Fee SimpleTitleholderAddress <br /> Job Address Lot # � <br /> Sub Division �� # <br /> � Bio-Hazard Waste Storage - ANtNUAL Q Fumigation TeM <br /> a Comm Exhaust lCitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Instadation <br /> Q Emergency Generator < 30 kw � LPINaturel Gas-Installation <br /> � Emergency Ger►erator > 30 kw � LPlNatural Gas-ANNUAL Sale <br /> a Fire Pmtection Mairrtenance - ANNUAL � Places of Assembly,ANNUAL ,� -- - <br /> � �� � � <br /> Sp�inkler � ❑ � ❑ � � Recreational Bum '2 <br /> Fre Alarm � o ❑ ❑ � � Sparlclers � <br /> � <br /> Hood Geaning ❑ � ❑� � Sprinkler System Installations <br /> Hood Suppressan � ❑ ❑ ❑� a Standpipes (Sprinkler Sys) <br /> � Flre Alartn Installation � Tor�h Roofinglfar Ketde <br /> Rre Pumps � Waste Tire Storage ANNUAL <br /> Rre Works <br /> FlammableApplication-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> er. <br /> Conbactor Comparry <br /> � � <br /> sig�ature r Registered Y/ N Fee currerrt Y/ N <br /> Address '� LiCense # <br /> ELECIRICIA Comparry <br /> Signature Registered Y/ N Fae Current Y/ N <br /> Address V��� # <br /> PLUMBER Company <br /> s�s�� Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> MECHANICAL ��y <br /> Signawre Registered Y/(d Fee Current Y/ N <br /> Address License # <br /> OTHER ���y <br /> S�9�� Registered Y/ N F� Current Y/ N <br /> Address License # <br /> _.W �.._.`__, �_... ..e._----.___ __ _.__ _ __ ___ _ <br /> Directrons: <br /> Fill out applicatbn completely. <br /> Owner 8 Contractor sign tsack of aPP�icatbn. notaraed (Or. copy cf signed coMract with ovvner) <br /> If over E2500� a Notice of Commenceme�t is required.(Mechanical work over $5000) <br /> Suppty two (2) sets of drawiru�s witl� appiicable documentatlon <br /> Ailow 1 Q14 days for review after subrtdttal date. Parcel #- obtair�i from Property Ta�c Notice (httpJlappraiser.pascogov.com) <br />