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s��-7ao-oo2o City of Zephyrhills�Firs� F�-8�3-�ao-aD21 <br /> Permit Application <br /> )ate Received � - Phone Contact for Permit �._��.�� <br /> �Ta:.sr-�.�:.���a.��x:,..a.�.w...�....�..a..v....� ���.�:azx��:�;�.�.,�.,......�_—___�.{-.,... ..�..,.,e,�..............�...�_,.T <br /> 7wner's Name L �-� �Mte�'S PhDne Number <br /> �wners Address � 1 l�. � �\ J -e' r l �' <br /> =ee Simple TiUeholder Name Titleholder Pfione Number � �� � <br /> =ee Simple Titlehalder Address <br /> ���.�� f,rA��c-'�'�!:�� <br /> JobAddress � Lot# <br /> ' � Parcel# S- � - V 'vj 7�� r� <br /> 5ub Division � �+ <br /> :-�_ ..��S�at2'�c'a�&r�'r-`'sYl's'f3:��'"ci..�i::e,�%F"r.T:�N-'�-�'�& <br /> � a 'BiaHazard Wasle 5torage-ANNUAL � FumigaUon Tent <br /> � Comm Exhaust Kitchen HoodlDuct � HazaMous Matsrial(71er li or RQ Facllify)ANNUAL <br /> � Cantroiled 6um � Hood Installatlon <br /> � Emergency Ganeratar<30 icw � LPJNaturel Gas-Instalistion <br /> Emergency Generafor>30 kw � LPlNatural Gas-ANNUAL Sale <br /> Fire Protection MaiMenance-ANNUAL a Places af Assembly-ANNUAL <br /> �y emi � er � <br /> Sprinkler � � ❑ O � � Recreatlonal Bum r (y�� <br /> Fire Alarm � O ❑ � � � 5parklers <br /> 1�L/ <br /> Hood Cleaning ❑ O ❑ � � Sprinkler System installations <br /> Hood Suppression � ❑ ❑ � C� � Standpipes(Sprinkler Sys) <br /> QFire Alartn installation � Torch.RoofingfCar FCetUe <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Firs Wodcs ' <br /> Flammable Applicatlon-ANNUAL Valuation of Project <br /> Fue{Tanks <br /> � �tfl@f: <br /> ��.5 T �^��_"'��,�..:.,.� <br /> Contractor Compsrry ' ? ',• t- � .� � '�r���r1�, <br /> Sfgnature � C' ' Registered Y N Fee Current Y N <br /> Address � l� � � �' �'' License# �V ►i� <br /> ELECTRICIAN Company <br /> 5lgnature Registered Y 1 N Fee Current Y/N �— <br /> Ac+dress Uaense# <br /> PLUMBER Company <br /> 5ignature Registered �(/�1 Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y�N Fee Current Y/N <br /> Address License# <br /> O7HER Company <br /> 5ignature Registared Y/N Fee Current Y/N <br /> Address License# <br /> ;��'�--.�:..:.: - a-m.���.....,_�;�, - -,:,�.e:.� - ---��...y;�-y.y.�>.,�,'��:�: <br /> Directions: <br /> Fttl out applicalion completely. <br /> Owner 8 Contractor sign back of applicatior�,notarfzed(Or,oopy of slgnad contract with owner) <br /> If over 52500,a Notice of Commencement is required(Machanical work over 35000) , <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for raview after submittal date. Parcel#-obtained from Property Tax NoUce(http://appraiser.pascogov.com) <br />