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MARj28/2007/WED 07:20 AM ZEPHYRHILLS BUILDING FAX No, 813-780-0021 P. 001 <br /> a��-78o-oflz0 City ofZephyrhlllsFine: Fax-a�aaso-oo21 !: <br /> permtt Appl(cstion •-- <br /> Data Recelved •Phone Ce�tactfor Permft <br /> Ownere Name � • Ouvner�Phone Number .� � <br /> Owne�e Addresa (1 <br /> Fee simple Tifleholder Name � � lltleholder Phone Number � �� � <br /> Kae�mpleTltlahaldtrAddress � <br /> JobAddreas ' LoE# ' � <br /> SYb DivislOn Paroel# <br /> Q81aHazardWaeteStorage—ANNUAL � � �� FumlgaUonTent , .., ,_ <br /> �.� Comm Exhaust Kilchen HoodlDUCt •� � Hamrdous AAeterlal(Tier 11 or RQ FeclAty) . . <br /> � Conirolled Bum F�od fnsialletbn <br /> � �mergency Generator<30 kw • � LPINaiurel 6as-InalallaUon ' Xn� <br /> � '�mergency Ganerator>3a kw � I.PMatural Gas-ANNUAL S , ���% <br /> Ftre fhotachon MaGrtanance=ANNUAL � Places vf Assembly-ANNU L <br /> ,7�.� ��"]y em� � B c�=� ►��J <br /> S rlrlkler � � O ❑ � � ReoteaUonal Bum • ����, <br /> P <br /> ' Fre Alarm � ❑ A' O � � 3psuWers : . (� �* , ��l n ��� <br /> � <br /> Hood Clasning � D� ❑ D � Sprinklar'3yslam InstaBations �� G. <br /> Hood 5uppression � {� d ❑ � � Stendpfpea(Sprhdclersys) � <br /> � Fi�a Alartn Nistanation , � Toroh Roafing/Tar KeWe , <br /> �R P�Ps - � Weste Tlre Stocage ANNUAL <br /> Ftre Worka ' ' <br /> Flammable ApplicaUon-ANNUAL , Valustion of Project <br /> Fuel Tanks � •• <br /> Q • Other: � � � � ���� <br /> convacfor C � Compsny <br /> Sigrrewro ' Repist�rod Fee Curreru N � <br /> Address �_ License# � <br /> �l.ECTRICIAN ' �P�' <br /> Signaturt Reg(sierecl • Y/N • Fee Current, Y/N <br /> Addreee License# � <br /> PLUMBER ��"Pa^Y <br /> Slg�eture Rae�stered Y/N Fee Curtant Y/N <br /> Addross � Llcenae# � <br /> MECHANICAI� ���Y �J <br /> signature Registered Y/N Fae Cument Y/N <br /> Address License# <br /> OTH�R ' Compe�Y <br /> signature Regiatered Y/N Fee Curtent Y/N <br /> Addreas ' • Llcanse# <br /> Directiona: <br /> Flll out aDDlication completaly. <br /> Owner&Coniractor eign baok of application,nolarized(Or,copy oi eigned coMract wlth ovimer) <br /> If ove�52500,a NotlCe af CammenCement ia requlrtd.(Mechenical work over$6000) <br /> Supply Mro(2)aeis of drawlnBe wilh appllcable documentatlon . <br /> Allow 1 D-14 daye for revleW ah9�au6mittal dWte. Parcel#-oblalned from Property TaX NoUce(httpJ/eppcaiaer.pascogov.com) <br />