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sisaso-oazo City ofZephyrhills'�ir�e�• Fax-81;r780.0021 <br /> Permit Application <br /> Date Received � � Phone Corrtact for Pertnit � <br /> � <br /> � �.. � <br /> Owner's Name L e � Owner's Phone Number .� r'�� <br /> L_ILL�!1 L.L.L_LJ <br /> Owner's Address y� �j�J- (� <br /> Fee SimpleTitleholder Name ?iUeholder.Phone Number r_� � � <br /> Fee Simple Titleholder Address <br /> �a <br /> Job Address / �� G // v Lot� C <br /> 5ub Division Parnel# <br /> � Bio-Hazard Waste Stordge-•ANNUAL Q Fumigation Tent <br /> � Comm F�chaust Kitchen HoodlDuct � Hazardous Material(Tter fl or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Gene2tor<30 kw � LP/Naturel Gas-Installation � <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Saie ` <br /> � Fire Protection Mairrtenance-ANNUAL � Ptaces of Assembly-ANNU <br /> ry ' emi �' er /J/�� � <br /> vf�i <br /> 5prinkler � ❑ ❑ ❑ � Recreationai 8um <br /> Fire qlarm � ❑ n ❑ � � 5parklers <br /> Hood Cieaning � ❑ ❑ ❑ � � Sprinkier 5ystem Ynstallati s <br /> Fiood 5uppression � ❑ � ❑ �� � 5tandpipes(Sprinkler Sys) ' <br /> � Fire Alarm Installation � Torch RoafinglTar KetUe <br /> Fire Pumps � Waste Tire 5torage ANNUAL <br /> Fire Works <br /> Ftammable Applioation-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> � Other: - <br /> Contractor Company <br /> 5ignature ' Registered Y/N Fee Curtent Y/N <br /> Address <br /> License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fes Gurrent Y/N <br /> Address License# <br /> PLl1MBER Company <br /> Signature Registered Y/N Fee Curtent Y/N <br /> Address . <br /> License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Addr=ss <br /> License# <br /> OTHER CompanY �/Ifej�+ ,rt�'r <br /> Signature Registerad Y N Fae Current Y/ N <br /> Address v License# �j <br /> . .... <br /> Directions: - <br /> Fill out appiication completely. <br /> Owner&Cont2ctor sign hack af application,notar¢ed(Or,capy of signed corrtract with owner) <br /> , tf over$2500,a Notice of Commencement is required.(Meehanical work over$SDDD) <br /> Supply 1wo(2)sets of drawings with applicable documerttation <br /> Allow'I D-74 days�for review after submittal date. Parcel#-abtained irom Property Tax Notice(httpJlapp2iser.pascogov.com) <br />