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8t3-78D-oo2o Clty of.Zephyrhills�Fi�e FaX-8�3-780-0021 <br /> Permit Application <br /> �ate Received � �pC, � ! Phone Contact for Pertnit ����� Q �� _� <br /> ::�sr.:t�^�.:a�Y..�.:�v;zr::�...:�,.. �. _...�.� - �'as--� — s�:,.'�*� - ..a� °.r�„�..�., ,rz��, <br /> )wners Name •, j iC.,. ��y Ow�ers Phone Num6er G3 � �S . 933' <br /> )wners Address � , ,fJV C.lV � v� � <br /> ee Simple Titleholder Name Titleholder Phone Number ���� <br /> ee Simple Titleholder Address <br /> ��� -�'�?==�f�-= ��'�o '. _>��::� - . - = ..,t�-4"^�,��' +_—." - -�--°-° .�..�:a-='='�zi��� <br /> ob Address OLL��i � � �/� $L , Lot # � <br /> �ub Division Parcel # <br /> � Bio-Hazard Waste Storage - ANNUAL � FumigaGon Tent <br /> � Comm Exhaust Kitchen Hood/Duct a Hazardous Material (Ter II or RQ Facilily) ANNUAL <br /> a Contrnlled Bum � Nood Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generetor> 30 kw a LP/NaWral Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> r y emi �n er <br /> Sprinkler � O D ❑ a Recreational Bum �_ j��/ <br /> �� f�n <br /> Fire Alartn � ❑ ❑ � � � 5parklers t <br /> �,/ I <br /> Hood Cleaning �{! � �� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ O � � Standpipes (Sprinkler Sys) <br /> � Fire Alartn Installation � Torch Roofing(Tar Kettle <br /> � Fire Pumps � �Naste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Applica6on- ANNUAL � Valuation of Project <br /> � Fuel Tanks <br /> a Other: . <br /> r�° - - - - : �.,-- . s���-s���-�- ��r��r.� u, <br /> :ontractor Company /v <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License � <br /> PLU MB Ef2 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 �' / I�l Fee Current 1' / N <br /> Address �icense # <br /> Directions: - - - - �� �� - - -- �_� � <br /> Fill out application completely <br /> Owner 8 Contrdctor sign 6ack of application, notarized (Or, copy ot signed conVact with owner) <br /> If over 52500, a Notice of Commencement is required (Mechanical woiic over $5000) <br /> Supply two (2) sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (httpJlappraiser.pascogov.com) <br />