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813-780-0020 City of Zephyrhilis Fax-sis-�so-oo2i <br /> Permit Application - <br /> Date Received �— � Phone Corrtact for Pertnit �� ��a� <br /> , . _.:i�3�i.""z� -. .., .. . �..��. wv..s....� :......a._a 8'�,4 .� ,....,,°�.-8i'.�;��"-.'£:�?k - ....,;F?'.f;l� - Y S` �,�:-- ; ._. ....:. <br /> Owner's Name ANDERSON PRES Owners Phone Number � RRG 5 �Q� <br /> o�,ers Add�ss 5104 MURRAY — <br /> Fee Simple TiUeholder Name Titleholder Phone Number �� � <br /> FeeSimpleTitleholderAddress _ _ _ � , ,�, <br /> ..g �-•v��: .-,...... �.,��?'a�.,,';���:�z"��a";>,s.�,`">�a . - �.e..� _.�._, - - <br /> ,°."'� �:'�.� �? �. �:..,, . . � � _ m. �x.i.��" �s���^''���:,�:;�wr'.°��:�:.,� ..... :•�'°�;- <br /> y,V '" :'� �e��'. . . _ � <br /> Job Address GOLDEN CORRAL 6HS �'iA�, BL�. Z'��H�� — Lot# y � C� <br /> Sub Division Parcei # <br /> ._._. . . ----�='t"�.?r'�''` ........� ._...-�:ar".°' . :.a . - . ':i�'R°�.`�'i� '4�.�:%���:-'"'"�u-"�_..-�+n�:3"a:__r:,-.<=.M.�....._',�"".�a;F- <br /> �� Bio-Hazard Waste Storage - ANNUAL a Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tiar II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generdtor < 30 kw � LP/Natural Gas-Installation ����j � <br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale � � <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> �y emi � r <br /> Sprinkler � ❑ ❑ ❑ � Recrsadonai Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Spa�lclers <br /> Hood Cleaning � ❑ ❑ O� � Sprinkler System instailations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alartn Installation � Torch Roofing/Tar Kettle <br /> Fire Pumps Q Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Appiication- ANNUAL Valuation of Project <br /> FueFTanks <br /> Q Other: �� J <br /> . � �e�'��� �t?�7.�� - <br /> a��ffi£ "_ a. �" ...v_ ;'.i <br /> Contractor Company <br /> Signature Registered Y/ N Fee Current Y/ NI <br /> Address License # <br /> ELECTRICIAN Company <br /> Si Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER Company <br /> Signature Registered Y/ N Fee Gurrerrt Y/ N <br /> Address License # <br /> -- �, .�...:,�.�,:::w:3.�.:�.:�.,a.:-• _ �<_....�,��..�-,�..��:x�-._::� ,..�,.��.,�.���-.:.�.-... . . � ��_ ._.,. <br /> + Directions: � �� .�_ <br /> FII oui appiication completely. <br /> Owner 8 Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> If over $2500, a Notice of Commencemerrt is required (Mechanical work over $5000) <br /> Supply two (2) sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained irom Properiy 7ax Notice (MtpJlappraiser.pascogov.com) <br />