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sti�-aao-;c�o City of Zephyrhills�Fir��• Fax-813-7R0-OD21 <br /> Permit Application <br />:Received � - Phone Contaetfor P�ertni�I S'7..L Iy�T,��9...�_._ <br /> c'�.�����—� <br />.st:��c;:•u.[�'Mi�'�:-P.�.„w...�,,....v..�.. - • <br /> iers Name ���1'� U (-- � � �wner's Phone Num6er �� �� � <br /> ie�'s Address l.Q � (�G.. � 1� /� -E � � � � �. <br /> Simple TiUeholder Name TiUeholder Pfione Number � � ,3 �� �-- <br />:Simple Titleholder Address <br />�°s.5"�;�.�'� i�^3f '�Ea''s,ts?l9�l:'���,�'g+�.e�:ti <br /> Address �G•.- �-�--. �,, �, e �ot# � <br />�Division pJ � �� Parcel# (� .3 ',pZ�O 'v�� • l��/U �U��'C� '(JL�� � <br />��.• �3��`�za��.rv��n��r:.�.�r�^xrs��-�� <br /> � Bio-Hazard Waste 5torage-ANNUAL Q FumigaUon Tent <br /> � Comm Exhaust FGtchen Hood/Duct � Hazardous Material(Tler II or RQ Faciliiy)ANNUAL <br /> � ConVo{led 8um � Hood lnstallaUon <br /> � Emergency Generator<30 kw � LP/Naturef Gas-Installation <br /> Emergency Generator>30 kw � LP1Natural Gas-ANNUAL Sale <br /> Fire Protectlon Maintenance-ANNUAL a Places af Assembly-ANNUAL <br /> �y emi ATn er <br /> Sprinkler � � ❑ ❑ � � Recreational Bum �('�, <br /> r2�j LJ <br /> Fre Alarm � p ❑ � � � Sparklers <br /> Hood Cleaning ❑ ❑ ❑ �� � SprinklerSystem Installatlons � <br /> Hood Suppression � ❑ ❑ ❑ C� � Standpipes(Sprinklar Sys) <br /> � Fire Alarm InstaltaUan � Torch RoofinglTar Kettle <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works • <br /> Flammable Appllcatlon-ANNUAL �� � Valuation of Project <br /> Fue(Tanks <br /> Q other: <br /> ��s.,,�,� <br /> ontractor Comparry i • ,� �.y.' �,� <br />,gnature ' Registered , Y. �I Fee Current N��» <br /> Addrass 1 - ' � Licer�se# ,`"J ty 1 t'� <br /> LECTRICIAN Compeny <br /> ignature Regfstered Y/N Fee Current Y/N <br /> Address License# <br /> LUfNBER <br /> Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> 1ECHANICAL Campany <br /> ignature Registered Y I N Fee Current Y/N <br /> Address <br /> License# <br />)THER Company <br />�ignature Ragisterad Y/N Fee Current �(/N <br /> Address License# <br />;A'�r.z'��s:..M,.._..�,...a_�....�,�._....:a,.:u.a�ua� . ... , <br />)irections: <br /> �..am.w�xi+�;Y�f.^:�. ..x1u.s� '_ '�.,�'a��v.e• <br /> Fill aut appUcation completely. <br /> Ownar 8 Contractar sign back of application,notarized(Or,copy of slgnad contrect with owmer} <br /> If over�2500,a Notice of Gommencement is required(Mechanicat work over 35000) <br /> Supply two(2)sets of drawings with epplicable documerrtaBon <br /> Allow 10-14 days for rsvisw after submittal date. Parcat#-obtained frorr�Propedy Tax NoUce(http:l/appraisar.pascogov.com) <br />