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r,7a-7saoozo City of Zephyrhills�Fiae� Fax-813-780-0021 <br /> Pet�mit Application <br /> 18i8 Received � - Phane ContaetforPermit �m� <br /> :�L'�bihffiRp9::xx+�.� , W�97R�r�Y83�SR�LIC` . �CBR�•,:w.�r..:Met.:.�c'-ars.�.w ...�„ ..�._ <br /> }wner's Name �G l., �t�c-h �t � � �.j Owne�'s Phone Num6er �►"� �� � � <br /> )wner's Address �.,t] �� � ' � � � 3� �'y ��' <br /> =ee 5imple TiUeholder Name Titlahoider Phons Number �� �� � <br /> =ee Simple 7ideholder Address - <br /> �eeo�w_mw� i3ftLs�;�n3�."�'�'^.��$�'�'f� <br /> ,,. , rx����v�...�..:.......___-- � <br /> Job Address ' Lnt# <br /> Sub Division } L �t�= � `7 Parce�# <br /> �3'��0`,�/ "��°�j`�r.�'j'c.���C7 Ll <br /> tdTA�d{k"�1�"H6'd!°e.��YT.4,�;c:�L4c,.,�.4�&.9F8'�� <br /> a Sio-Hazard Waste Storage-ANNUAL a Fumigatlon Tent <br /> � Comm Exheust Kttchen HoodlDuct � Hazardous Material(Tter H or PQ�acilify}ANNUAL <br /> � Controued Bum a Haod Instaltation <br /> � Emergency 6enerator<90 kw n LP1Naturaf Gas-Ins#allation <br /> Emergency Generatar>30 kw � LPINaWral Gas-ANNUAL Sale <br /> Fire Protecdo�Mairrtenance-ANNUAL a Places of Assembly,ANNUAL <br /> il�r y emi RTn er <br /> 5prinkler � ❑ ❑ O � � Racreatlonal Bum �� <br /> Fire Alams ❑ ❑ }�1 L J � Sparklers ( �� <br /> Hood Cleaning � O ❑ �❑ �] � Sprinkler System instaliatlons ` <br /> Hood Suppression � D ❑ Q �� a Standpipes(Sprinkler Sys) <br /> � Fire Atarm InstallaUon � Torch.RoaflnglTar Kettfe <br /> Fire Pumps � Weata'{'fre Storage ANNUAL <br /> �ira Works ' <br /> Flammabla Appllcatlon-ANNUAL Valuafion of Project <br /> Fuel Tanks <br /> C] Other: <br /> ��s�� <br /> Contractor � Compeny ' � '�• •` •�– � 'lr� �'1+� <br /> Signature � ' Registered Y N Fee Cucrent �1 � <br /> Address � 1 � � ' r'- " ltcense# � � W J�! ��H �: � <br /> ELECTRICIAN Campeny <br /> 5lgnature Registered Y/N Fee Gurrent Y/N <br /> Address llcense# �—_ � <br /> .r.�....�__�.__. r--- <br /> PLUMBER Company <br /> Signature RegisterEd Y/�1 Fee Currenl Y/N <br /> Addrass Licensa# � � <br /> MECHANICAL Company <br /> Signature Registered Y!N Fee Current Y/N <br /> Address License# � � <br /> O7HER Company <br /> 5lgnature Regietered Y/I�! Fee Current Y!N <br /> Address License# �— —, <br /> '�FI�Ifi3E�S�_ umos..xr�n �u.7r..� a�"r'"�+'s�XlAI�L'i� ..es�,w,e .zrm.••••. �x���,._��^• <br /> _a2C'.g(s°'.S,WC"' <br /> UlrecUons: <br /> Fill aut applicaifoa completely. <br /> Owner 8�Contractor sign beck of applicatior�,nutarized(Or,copy of slgnad cvntract with vwner) <br /> If over 5250�,a Notica of Commencement fs requlred(Mechanical wvrk over 35o0U) . <br /> Suppfy two{2)sets of drawings with epplicable documentaUon <br /> Ailow 10-14 days for revfew after submfttal date. Parcel#-abtained from Propedy Tax NoUce(http:llappraiser.pascogov.com) <br />