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, <br /> � �!AR��28%2007/WED 07:20 AM ZEPHYRHILLS BUILDING FAX No. 8[3-780-0021 P.001 <br /> 8137$0-OUZO CityofZephyrhillsFine� � � Fax-ataaeo-oo2t �� <br /> permft Appltcation •-- <br /> Data Recaived .. • . ',- .Phons�1or Permlt . <br /> Ownere Name • awner�Phone Number � � � <br /> Ownera Addreoe O g� � <br /> Fea Simple T1Ueholder iJame � ' ' • lltleholdar Phohe Numbar � � � <br /> �ee�mpleTltlehaldtrAddres3 ' � ' ' <br /> • � . . . • ��Lot# • � <br /> Job Address ' ' ' ' <br /> 5ub Divtslon Paroel# <br /> �mvavtu�imyy�asenm.-�minni rhr� <br /> � Blo-Hazard waete Storage—ANNUAL • � " � FumlgaUon 7ent , • . <br /> � Comm Exhaust K�lchen HoodlDUCt: •' �• Hazardoua Malerial(fier 11 or RQ Feclliry)ANNUAL , <br /> �� Controlled 8um � Nnod(n9talleUon ' <br /> O �mergency Generator<30 kw • . � LP1Naiurel6as-inebliatlon ' <br /> � '•Emergency Ganerator>30 kw ••, � ,l.PlNatur�l Gas-ANNUAL Sele . <br /> Flre Protac6an Nfafntenance=ANNUAL. a Places of AssemblY-ANNUAL ' <br /> . . � y em� �� . � <br /> SpdnWer � p " ❑ ReoteaUonal Bum ; . <br /> • � Fre Alartn �. � I7' ❑ �� � 3Pwklers : .• . • "—r,,`� <br /> Hood Claening � O� O O� � � SPrinkier'3yolem Instntladons : ���`�„�^ _� �� n <br /> L'.r�C)U '' �� <br /> Hood 5uppresslon � {] d ❑ �� , � Stendpipes(Spdnklersys) U� <br /> ' O F�e Alamt Ineta�ation . . . � TorCh Roafiing/Tal'KeWe; . . �(�� r,I ,��13 <br /> Flre Pumpa ' ' ' � ' ' � � Waste 71re Storage ANNUAL . , �.J� <br /> Flro Worke ' • ' • � • • � <br /> . Flemmable AppRcaOon-ANNUAL • •• •�_�+� • ValueUoTl of P[ojeCt . <br /> Fuel Tank6 . � � � � <br /> Q • Other: ' ' ' ' ' <br /> conuactor . , • . . • Company <br /> Signawre ' Registered Y V Fee Current Y N • <br /> Address � Lipense#F <br /> �I.ECTRICIAN � � . ' � � Comperry • <br /> Siynaturc ' Reglslerecl• Y 1 N • Fee Curtant• Y/N <br /> Addrese License�l ' � <br /> PLUMBER • . Campany —� <br /> Slgnature � � Reglstered Y/TI Fee Curtent Y/N <br /> Addrass � Llcenea# • • <br /> MECHANICAt. ��'�Pa�Y <br /> Signature � Reqlste�ed Y/N Fae current Y/N <br /> Addre9s •Licaqse#. <br /> OTHF-ft ' Company ' �� <br /> signature � � Reg�atered Y/N Fea Curtant Y/N <br /> Addreea � • ' Llcenea# <br /> . <br /> Direction&: . <br /> . Fltl oUt applicafion compiately. <br /> Owner&Coniractor eign baok of applicalian,notatized(Or,copy of aigned cortract wlth ovimer) . . <br /> If over S25oo,a Notice of�mmencemaM is reqwred.(Mechanical woirk wer$6000) • <br /> 5upply two(2)eals of drawlnBe vn'lh appllcabie docuinentaUon . <br /> Aliow 1 D-14 daye for revlaW aher eubmiflal daie. Petcel#•obtafned from Property Tax NoUce(httpJ/appreiaer.pascogov.cam) <br />