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aia-7ao-oo2o City of Zephyrhills�Fir�• Fax-sts-7ao-ooz� <br /> Permit Application <br /> )ate Received - Phone Contactfor Permit _ _ _ _� <br /> �. - <br /> :�:�s�� �-,�.�.,.�... ' �� � � <br /> hvners Name �� "� � � et'5 Phone Number <br /> �wnePs Address � .�[� �c:� ` 1 { � � , ( � ` � � } � � <br /> =ee Simple TiUeholder Name Titleholder Phone Number <br /> � ! 3 � " '1 <br /> =ee Simple Titleholder Address ;�.����.c <br /> � Lat # C <br /> Job Address 1n" �— <br /> Sub Division \ � /1 � I Parcel # �J � "�: ' �� - G � °�L� "v �' G � - � � 1 E '� <br /> �����z ���.�� <br /> a Bio-Hazard Wasie 5torage - ANNUAL � Fumigallan Tent <br /> � Comm Exhaust Kitchen HoodlDuct � Haze►dous Matedal (Tier li or RQ Faciliiy} AtJNUAL <br /> � Controlled Bum a Hood Installatlon <br /> � Emergenay Generator < 30 kw � LP/Naturel Gas-Installation , <br /> Emergency Generetor> 30 kw � LPINatural Gas-ANNUAL Sale <br /> Firs Protectlon Mairrtenance -ANNUAL � Places of Assembly-ANNUAL ���., <br /> �y emi � er � /h'� <br /> Sprinkler � ❑ O ❑ Recreadonal Bum l� <br /> Fre Alartn ❑ ❑ � 5parklers _ <br /> Hood Cleaning � ❑ O ❑� � Sprinkier System insta{latlons <br /> Hood Suppression � d ❑ O� � StartdplPes (Sprinkler Sys} <br /> � Fire Alarm Installa8on a Tarch RoofinglTar Kettle <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Wo�lcs ' <br /> FlammableApplication-ANNUAL Valuation of Project <br /> Fue( Tanks <br /> � Other: <br /> ' ConUaotor � Comparry -�`� •`- ���-�!�� <br /> Signature ' Registereil Y N Fee Current N <br /> Address ,, \ - ' � Lice�e # � b 1 t7 <br /> ELECTRICIAN Company <br /> 5lgnature Registered Y I N Fee Current Y/ N <br /> Address Ucense # <br /> PLUMBER � Comoany <br /> 5ignature Registered Y/ N Fee Curtent Y/ N <br /> AddrBSS License # <br /> MECHANICAI Company <br /> Signature Registered Y I N Fee Current Y J N <br /> Address License # <br /> OTHER CompOny <br /> Stgnature Registered Y/ N Fee Curtent Y/ N <br /> Address License # <br /> -- - �_ . °n.�-s.�w - -.�..� - - --°,n..au�.e�x5vm��.�_,:.-�,�.n,e:a.� <br /> D3rections: <br /> Fill aut application completely. <br /> Owner 8 Contractor sign bacic of application, notarized (Or, copy of slgned contraci with owner} <br /> If over 52500, a Notice of Commencement is required (Meehanical work over 35000) . <br /> Supply two (2) sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittaV date. Parcal #- abtained from P�operty Tax NoUce (http:!lappraiser.pascogov.com) <br />