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s��-�ao-oo20 ° Cifij of Zephyrhills�Fice� Fax-s13-7so-oo21 <br /> Permit Appiication <br /> )ate Received —� Phone �(—'-'—� <br /> .��s:.,e��r.r�it:.;�t�;r�:.,o.�..�,.�. -�,...�,�°^°°..,�,— �� _ ' Contaet,��'��t .. ..,�...�..�.:� - --4T� <br /> —°...�,.�.:,��, �. �:L— <br /> hnmers Name �► -e ��� Owner's Phone Number �� �� �`J`�l��/ <br /> L <br /> ��,imer's Addrass ��3J � �„e �• �� � <br /> =ee Simple Titlehoider Name Tttleholder Phone Number � C� � <br /> =ee Simple 7itleholder Address <br /> �:�'=h�f;is;'"s�.�'��,.'^".��.s�' . <br /> �''��.�'m"�'�' '' i�r-�as i`�^�'��,sk'�.�?s <br /> Job Address 'S �� 3 X 303�1• �Q �� � <br /> Sub Division Parcel# — — � •(,b� ' (}Q�Q� ��0 <br /> i'.N'Ti.`v;.��+=r'-"-�'�y�"fk�`1�Yi�'ra"4'�'� ' �a�esz ec�,ymee- . ._._---- ------ <br /> � ' ��.xa au3a.`+:ixk''�7:5��ie�i�E°a:5;:�2i�`d:�r ti-:Ft.'n'��::��:�:'-_=.''+y`a:9:s'�x..�`s5 <br /> 9io-Hazard Waste 5totage-ANNUAL � FumigaUon Tent <br /> � Comm Exhaust fCitchen HoodlDuct Q Hazarclous Material(Tier I�or RQ Facili{y}ANNUAL <br /> � ConVolled 8um � Hood Installatlon <br /> � Emergency Generatnr<30 kw � LP/Naturaf Gas-Installation <br /> Emergeney Generator>30 kw � LP/Natural Gas-ANNLfAL 5ale <br /> Fire Protection Mairtenance-ANNUAL Q Places of Assembly-ANNUAL ���� <br /> ❑ r y emi n�'f er � � � <br /> Sprinkler ❑ ❑ p Recreational Bum <br /> Fre Alamt � ❑ ❑ �j � � Sparklers <br /> Hood Cleaning p p /❑ C� � Sprinkler System installatlons <br /> Hood Suppression � p ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> aFire Alarm instailati�n � Torch Rooflng/Tar Kettle <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Worics • <br /> Flammable Applicatlon-ANNUAL Valuation of Project <br /> Fue{Tanks <br /> � ot�lEf: <br /> �:����-�°i_'F'F��s�rx,-ea�: <br /> Contractor :"�„�'•�,!=�.,�r:w��-t�--�x-,F��_'=-'�'1�-_.'� <br /> Comparry y '�. , .� .a� � '3��t _ t; <br /> Signature RegisteratJ Y N Fee Currant nj � <br /> Address a �c � _ '� � � �-��•- License# '+ <br /> J� �J <br /> ELECTRICIAN <br /> 5ig�ature <br /> Company <br /> Registered Y/N Fee C;urtent Y/N <br /> Address <br /> License# <br /> PLUMBER <br /> Signature <br /> Company <br /> Registered Y/N Fee Gurrent Y/N <br /> Address �— � � <br /> License# <br /> MECHANICAL <br /> Signature Company <br /> Registered Y/N Fee Current Y/N <br /> Address �— � � <br /> License# <br /> O7HER <br /> 5ignature <br /> Company <br /> Registered Y!N Fee C:urtent �'/N <br /> Address � � <br /> �A�'�=.'.- - �.�.s,:�,,,.,�;�„�,�,a,�.�..,W, License# <br /> Directions: - - --- ���„�.,,.,.�,�,<„s�-� <br /> _. ,.. ..:__._ _ -�_ ri�i^.�..'r".uL�f:: <br /> Fill out application completely. i�-- <br /> Owner 8 Contractor sign back of applicatior�,noiarized(Or,copy of signed contract with owner) <br /> If over�250D,a Notice of Commencament is required(Mechanica!work over 35000) <br /> Suppiy two(2)sets of drewings with applicable documentation <br /> Allow 10-14 days for r�view after submittal date. Parcal#-obtained from Property Tax Notics htt //a <br /> ( p: ppraiser.pascogov.com) <br />