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613 City ofZephyrhilts'Fi�- <br /> Fex-813-780-0021 <br /> Permit Application <br /> Date Fteceived ph� C p� <br /> Ownet's Name �' (7 !�' ✓' Owr�'s Phone Nimiber ' C i� l�� �] i�-=:L_ <br /> Owners Address 1 1 � / �) /'I � � Q /' h ��� <br /> Fee Simpfe Trtleholder Name �Trtletnlder Phaie Nurt�ber �� C� C <br /> Fee Simple TiGeholder Add <br /> Job Address V Q � Q h/�hI �� � <br /> Lot # L �� — <br /> Sub Division par�c� # <br /> � Bio-Hazard Waste Storage -ANNUAL � �� �� � _ -- <br /> � Comm Exhaust Kitchen Hood/Duct � Hazandais Materiaf (Tier II or Faciiity) ANNUAL � <br /> � Coritralled Bum � � � ��� ) � <br /> � EmergencY Generator < 3D kw � LP/N�ah�ral �� <br /> � Emergency Cxnetator > 3D kw � LPiPtahnal Gas AN UAL Sele <br /> Fre Protection Maintenence - ANNUAL � Places of UqL _ <br /> � �.� � �// ' <br /> 5prinkler � ❑ ❑ ❑ � � Reaeatio�l Bum � <br /> ❑ � 0 0 ( y�� , <br /> ��� o o S�� <br /> liood Cleenin9 � ❑ D ❑ C� � SprinkierSysiem k�stallatiwis <br /> liood SuPPression � � O ❑� a SYdndpipes (SPrinider SYs) <br /> � Fre Alartn Insfallatipn � To�h RoofinglTar KeUle <br /> Fire Pumps Q Waste Tire 5tarage ANNUAL <br /> Fre Works <br /> Flammabie Application. ANNUAL � Valuation of Ptoject <br /> Fuel Tanks <br /> � Oiher' - <br /> Contractor �� <br /> s;9nature ' t�egisroered Y/ N Pee cunent Y/ N <br /> Aaaesss ' ucense # <br /> �' � ��+y u sell Electrical Eonst <br /> 5ignature � -��- �� � Registered Y/ N Fee Curtent Y 1 N� <br /> Address � # <br /> PLUMBER �� <br /> Signature Registerad Y/ N Fee Curterrt Y/ N <br /> Address • �� # <br /> MECHANICAL �� <br /> Signatute ' Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER <br /> Comparry <br /> Signa4�re Registered Y/ N Fee Gurrant Y/ N <br /> Address ucer�se # <br /> Directions: , . - <br /> Fill out apptication cort�pletely <br /> Owner 8 Contraetor sign back of aPP�etion. rataraed (Or, copy of signed conhract with owner) � <br /> � FE over S25D�. a Notice of Camm�cement is required.{Med�enical work arer $5Q00) <br /> Supply two {2) ssts of drawings wNfi appticab{e docurnert�orr „.... <br /> Allow 1 D-14 day,s for review atter submittal date. Partxl #-�ohfalned'ftom PropeAy Tax Notice (htlpJ/aPP��r_pascogov.com) <br />