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s��-�ao-oo2o City of Zephyfiills�Fi�- Fax-al3aso-oa21 <br /> Permit Application <br /> )ate Received _ - Phone Contact far Permit (��� <br /> �� --- a�,,x�,L-�—..�.--w-----'�,,..�,��""._,...�.,...�__.. <br /> :�.s���::r+���` �------�--- �- <br /> hvners Name � G� � n h a n �� 1�1.� �►e�s Pho�e Nurttber � �� <br /> �wner's Address ? J � �`- b � C,t s'� � ` h -�„ '�' e L � '3 �js a S <br /> =ee Simple Titleholder Name lideholder Pfione Number ��� <br /> =ee Simple Titlehvlder Address �,.�a� <br /> � 3 3 5 L R 5 �C. � e. t' `a s �oc # <br /> Job Address C <br /> Sub Oivision 1 p� �� + Paroel # " a � � � (�' OAI�U� ' U � �� <br /> �..���wn.,�.�� <br /> � Bio-HazaRi Waste 5torage - ANNUAL Q Fumigation Tent <br /> � Comm Exhaust Kitchen HoodlDuct � Haza►dous Matedal ('Rer {i or RQ Facilify) ANHUAL <br /> � Controiled Bum a Hood InstallaUon <br /> � Emergenoy Generator < 30 kw � LPlNaturef Gas-Installation <br /> Emergeney Generetor> 3D kw Q LPlNatural Gas-ANNUAL Sale .�� �� <br /> Fire ProtecBon Mairstenance - ANNUAL Places of Assembly-ANNUAL �� <br /> � ami � er � <br /> Sprinkler �❑ O O RecreaHonal Bum <br /> Fre Alartn ❑ � }�1 � � Sparklers <br /> � � � Sprinkler System installations <br /> Hood Cleaning ❑ � � <br /> Hood Suppression �❑ Q O� � S1andPrPes (Sprinklar Sys) <br /> � Fire Alarm Installation � Toccfi Roofingfiar FCettle <br /> Fire Pumps a Waste Tire 5torage ANNUAL <br /> Fire Works ' <br /> Flammable Applicatlon-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> � �fflBf: <br /> m"'�y.�,K'sa'� <br /> 'Contraotor Company ��� ��- ��"� �L� <br /> Signature i ' Registered Y N Fee Current �l <br /> Address 1 � license # i� tl � t7 <br /> ELECTRICiAN Company <br /> 5lgnature Registered Y/ N Fee Current Y/ N <br /> Address Ucense # <br /> PLUMeER Company _ <br /> Signature Reglstered Y/ N Fee Gurrent Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y 1 N Fee Current Y/� <br /> Address License # <br /> OTHER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> '+"Pi�'�is� - � �. = _ — :..� � a.ma,s��.� .�„�,°brxrs«*s <br /> Directions: <br /> Fill aut appiicaUon complstely. <br /> Owner & Contractor sign back of applicatior�, noiarized (Or, copy of signad contraci with owner} <br /> If over 52500, a Notice of Commencemant fs required (Mechanicai work over 35000) . <br /> Supply two (2) sets of drewings with applicabie dacumerrtation <br /> Allaw 10-14 days tor review aiter submittal date. Parcal #- abtained from Property Tax Notlas (http:l/appraiser.pascogov.com) <br />