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. �;s�au-c�2o City of Zephyrhills�Fir�� Fax-813-780-0021 <br /> Permit Application � <br /> )ate Received - Phone Contact far Permit ������� <br /> :�.sx��x�;:� .,,..�,.�..0 +r�c.r�R...e:,�.�.,..m� .. .. _.. . <br /> h�mers Name � �`,..e. O�Mtet'S Phone Num6er � �2�_��� <br /> �wners Address � � �c7 � � Z ' �j 3 rj ' <br /> =ee Simple T�leholder Name Titleholder Pfione Number � � � <br /> =ee Simple?itleholder Address <br /> , �s`'�'�"�"��' <br /> 1ob Address �����'� {� -C � � �� �� - l��l.'U''e . �� r •(,�$ Lat# C <br /> Sub Division Paroel# Q� '� '�� • �Q� U� v(� o� <br /> - �x��A� <br /> aBio-Hazard Waste 5torage-ANNIlAL � FumigaUon Tent <br /> Q Comm Exhaust IQtchen HoodlDuct � Hazardaus Material(7ler fi or RQ Facility}ANNUAL <br /> � Contrafled Bum � Hood Installatlon <br /> � Emergency Generator<30 kw � LP/NaWrel Gas-Installation <br /> Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> Flre ProtecBon Mairtenance-ANNUAL a Places of Assembly-ANNUAL <br /> �y amt � er <br /> 5prinkler � ❑ ❑ ❑ � � Recreadonal Bum <br /> Rre Alartn � O ❑ � � � Sparklers <br /> Hood Clesning ❑ O ❑ �� a Sprinkler System installations <br /> Hood Suppression � � Q O �� � Stancipipes(SprinWar Sys) <br /> aFire Alarm Installation � Torch Roofingffar KetUe <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works • <br /> Flammable Applicatlon-ANNUAL r��� Valuation of Project <br /> Fue(Tanks <br /> Q Other: <br /> � <br /> Contractor Comparry �'� .G � L', <br /> Signature ' Registered Y N Fee Current (�1 <br /> Address � 1 - ti ' License# ��3 i Z7 <br /> ELECTRICIAN �mRam <br /> Signature Registered Y/N Fea Current Y/N <br /> Address llcanse# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signatvre Registered Y/N Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> 5ignature Registered Y/N Fee Current Y/N <br /> Address <br /> y,,,�,�,,.�,,., Liaense# <br /> , �� ��-z .,______�-�-- .�..�_._....,_....� . - <br /> �.,._. .__ ..�-_ �- :- <br /> DirecUons ` _ '- �'"."„"°."°" <br /> Fill out appl3cation completely. <br /> Owner 8 Contractor sign back of appficatfon,notarized(Or,copy of slgned cvntract with owner) <br /> If over 52500,a Notice of Commencement fs required(Mechanicaf work over 35000) <br /> Supply two(2)sets of drawings with applicable documerdation � <br /> Allow 10-14 days Tor review after suhmittal date. Parcel#-obtained frorn Property Tax Notics(http://appraiser.pascogov.com) <br />