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`�— �s13-780—OU20 <br /> City of Zephyrhills Fir�• Fax-$�saso-oa2� <br /> ' � Permit Apptication = <br /> Date Received Phone Corrtact for Pertnit .�,�� t -.ig <br /> «:�,..._, .Y. ��>�.�-..�---��..b. <br /> �. _ -�.����: <br /> Owners Name �i1QD�$�N � Owner's Phone Number � L� Cj� <br /> Owners Address_ 51�F �Y ' <br /> Fae Simpie Titlaholder Name Titletiolder Phone Ntanber � C� C� <br /> Fee SimplelitleholderAddress <br /> .., -i��: <br /> Job Address GOLDEI�T CORR.AL C HS S GALL BLVD. Z� — Lot# C--� <br /> Sub Division Paroel# <br /> �'..�__:: - ._ �,� <br /> ,��.'�`�---_., <br /> � Bio-Hazard Waste Storege-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Harardous Material(Iier II or RQ Facility)ANNUAL <br /> � Conholled Bum � Hood Instaltatian <br /> � Emergency Cenerator<30 kw � LPMatural Gas-Installatfon <br /> � Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Sale <br /> a Fire Protection Mairrtenance-ANNUAL � Places of Assembly-ANNUAL <br /> �y m� � r �� <br /> Sprinkler � ❑ ❑ � � � Re�reational Bum ]� <br /> �i I <br /> Fire Alarm � ❑ ❑ 0 � � Sparklers ' ("1 <br /> Hood Cleaning � ❑ ❑ O � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � ��P�P����r SYS) <br /> � Fre Alartn lnshdllation � Toroh Roofing/Tar Kettle <br /> Fre Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Appfication-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q 0�'1@f: <br /> � - <br /> Corrtractor CompanY <br /> Signature ' Ragistered Y!N Fee curreM Y/N <br /> Address Licerue# <br /> ELECTRlCIA ���Y <br /> sigrrature Registered Y/N Fee Cument Y/N <br /> �d� License# <br /> PLUMBER CO��Y <br /> S�9�� f2eg�stered Y/N Fee Current Y/N <br /> Address - License# <br /> MECHANICAL CO�rn <br /> 5�9�� Registered Y/N Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature <br /> Registered Y/N Fee Currerrt Y/N <br /> Address License# - <br /> DirecUons: <br /> FII out application mmpletely. <br /> Owner S Contracbor sign back of application,rmtar¢ed(Or,copy of signed contract with owner) <br /> tf over$2500.a Notice af Cortvnencement is required.(Mechanical woric over$5000) <br /> Supply two(2)sets oF drawings with a�licabie documeMation <br /> Allow 90-14 days for review after subrtilttal date. Paraef#-obtained from Property Tax Natice(htlpJlappraiser.pascogov.com) <br />