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813-780-002o City of Zephyrhills'Fir�� Fax-813-7R0-0021 <br /> Permit Application <br /> de Received �_ � - Phone ContaetforPermit ���_d�T� <br /> w.^gr'>�-�t;:`_'w.,w��:;�'�u: :,..m,��...�c.�w:o �- �s., �°nY'"u."•��.+.�.-.�.' . .. . . ... _ <br /> Nners Name 1 � �( � S . 1 � Owner'S Phone Numher �� ,l'�� <br /> Nners Address l„Q t � Z � ` <br />�e Simple'IiUeholder Name TiHeholder Pfiona Number �� � � <br />:e Simple Tideholder Address <br />�'.,�."a.'"�€.i'�'�..� ����7l�'�1�7:�i�j+EZ�.�i'a�"sk <br /> ihAddress Lat# C <br />�b Division � ; Parcel# '„�l ',�-� "(�(�/(� ' Q a L//J/� -Uv,,� � <br /> a�;�ifc�=-4.•v�3:a.�is�'�' - �:'.L3li�.��F:'�'�n��Tt::=;�:.m�3P:ti.R,�=�3�.fi:.*'x...'� <br /> a Bio-Hazard Waste 5iorage-ANNUAL � FumigaUon Tent <br /> � Comm Exhaust Kltchen HoodlDuct � Haza�dous Matedal(Tier{i or RQ Facility}ANNUAL <br /> � ConVolled Bum a Hood fnsiallation <br /> � Emergency Generator<30 kw � �PlNatural Gas-Installation <br /> Emergency Generator>30 kw � LPlNaturai Gas-ANNUAL 5ale <br /> Fire Proteotion Maintenance-ANNLIAL � Piaces af Assembly-ANNUAL <br /> �y emi � er <br /> Sprinkler � ❑ ❑ O � � Recreational Bum /�� �(p <br /> . C�� ❑ �� <br /> Fre Alartn ❑ ❑ �I Sparklers <br /> Hood Cleaning O ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ p �� � Standpipes(Sprinkler Sys) <br /> � Fira Alarm InstallaUon � Torcfi.RoofinglTar Kettle <br /> Fire Pumps � Waste Tlre Storage ANNUAL <br /> Firs Wotks � <br /> Flammable Applicatlon-ANNUAL r���� Valuation of Project <br /> Fuei Tanks <br /> Q Other: <br /> x�zr-�+,�. <br /> '�-�-:�-�t=- <br />:ontractor � Comparry �=', ,� i -j � <br /> ilgnature � ' Registered • Y N Fee�� Y N • <br /> Address J � � � Licerlse# ��}, ►� <br />:LECTRlCIAN Company <br /> iignature Regfstered Y/N Fee Cutrent Y/�— <br /> Address <br /> License# <br />'�UM9�R Company <br /> 3ignature Reglstered Y/N Fee CuRent Y/N <br /> Address <br /> License# <br /> NECHANICAL Company + <br /> 3ignature Raglstered Y/N Fee Cur�ent Y/N <br /> Address <br /> license# <br />�THER — <br /> Company <br /> 3ignature <br /> Registered Y/N Fee CuRent Y/N <br /> Address <br />;��-� � � y�� License# <br /> . . <br /> 7�rections �-°.�...�.�.--.�..y�a���.- <br /> - T— .. ._... �_�..x:z,..,s� —_ .�� <br /> Fill au[applicatlon completely. � <br /> Owner 8 Contractor sign back of applicat�on,notarized(Or,copy of slgned cantract with ownar) <br /> If nver$2500,a Notice of Commencement is required(Mechanica!work over$5000) <br /> Supply two(2)sets of drawings with epplicable documerdation � <br /> AIIow 10-14 days for review after submittal date. Parcel#-obtained frore Property Tax tJotics(http:/lappraiser.pascogov.com) <br />