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s�a-�ao-oo2o City of Zephyrhills�Firs• Fax-813a8o-oo21 <br /> Permit Application ' <br /> )ate Received - Phone Contaet for Pertnit �� <br /> e�rr.���;.zc ,,,_.,...,...�..,.....� � ,�..�.....�,,..�.�a.�T <br /> Rvwc , � <br /> hvne�s Name 1 e�j (� u rL Owner'S Phone Number L—J.�.�1.1 �L._I-1�1� <br /> �wners Address ( � ( '� �� 3 3� a. <br /> 'ee Simple TiUeholder Name Trfleholder Phone Number � � � <br /> =es Simple TiUeholder Address <br /> '�� • �,+x�:s'�'�-� <br /> Job Address �c-�.A, �'Y� �� Lot# � <br /> Sub Division Parcet# <br /> �. <br /> . �.���,�azM;�.��.,�� <br /> a Bio-Hazard Waste 5torage-ANNUAL � FumigaUon Tent <br /> � Comm Exhaust fdtchen HoodlDuct � Hazardous Material(7ier li or RQ Faciliiy)ANNUAL <br /> � ConVolied Bum � Hood Installadon <br /> � Emergency Generator<30 kw � LP/Naturai Gas-InstallaBon <br /> Emergency Generatar>30 k�u � LP/Natural Gas-ANNUAl.5ale <br /> Fire Protection Mai�tenance-ANNLIAL a Places of Assembly,ANNUAL <br /> �y emi A"Tn er <br /> Sprinkler � ❑ O O � � Recreatlonal Bum <br /> Fire Alarm O ❑ � � Sparklers i ' ��� <br /> Hood Cleaning � ❑ p � � � Sprinkler System Installations <br /> � <br /> Hood Supp►ession � ❑ ❑ p � a Standpipes(Sprinkier Sys) <br /> � Fire Alartn Instalia8on � Torch.Roofing/Tar KetUe <br /> Fire Pumps � Waste llre Storage ANNUAL <br /> Firs Wo�lcs • <br /> F{ammable Applicatlon-ANNUAL <br /> Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> �z <br /> � <br /> ConUaotor _,-a ComPany °'� .cr '7t'=tw ' E:, <br /> Signature ' Registerecl Y N Fee Current N <br /> Address ,,, 1 � License# �b �� <br /> ELECTRICIAN <br /> Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> PLUMBER <br /> Company <br /> 5ignature Registered Y/(�f Fes Curtent Y/N <br /> Address <br /> License# �— <br /> MECHANICAL <br /> Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> OTHER Company <br /> Slgnature Registared Y/N Fee Current Y/IV <br /> Address License# <br /> �,` `.'°=�m.� ..�..�_a..: <br /> �irections: � __,.,�,,.._;,�,.;�;.�x;,�,��r <br /> Fitl out applicaUon completely. <br /> Owner&Contraetor sign baek of appii�aUon,notarYzed(Or,copy of signed contract with owner) <br /> if nver 52500,a Notice of Commencsment fs required(Mechanicat work over 35DOa) <br /> Supply two(2j sets of drawings with applicable dacumentation <br /> Allaw 10-14 days for rsview after submittal date. Parcel#-obtained from Property Tax Nollce(http://appraiser.pascogov,00m) <br />