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From: 08/27/2014 12:29 #903 P.001/002
<br /> 813-78{7-OQ2G City o�Zephyrhills Fire Fax-813•784-0021
<br /> � Per it Application
<br /> Date Received ��� Phone ConWct for Perrnit �-�+.---T--t
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<br /> Ormer's Name . ��.e�{� ��� !�O LL.� f� IQ�J t i� - �,Q,S Cfwnets Phane Number p� . ��� � j �
<br /> Ownet's Address ��fo l n� i >� J� - h�I I F-L_ 5�-I�
<br /> Fee Simpte Titiehatder Narne Titiehotder Phone Number �� �� ��
<br /> Fee Simple Titleholder Address
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<br /> ��C��•-�ob'Address f�g�1 L_':.�C h-# � *�S T 'G--e.r `, ��1 r� }-�~.� �I,Z.- ^C. F-��..: �.L.ot#, L�
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<br /> Sub Divlslon Parcel#
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<br /> � Q Sio-hf�zatti Waste Storag8-fWNUAI r � Fumigafion Ten!
<br /> � Gomm Exhausl Kilchen HoodlDuct � Ha�ardous Materiaf(7ier II or RQ Faaliity)ANNUAL
<br /> QControlted 8um � Hood InsfaiiatiflR
<br /> � �mergency Generator�30 kw � LPlNaWra!Gas-Installation
<br /> i � Emergency�eneratar>30 kw Q LP1ht�tutal G8s-ANNt1AE.Sale
<br /> � Fire Proteailon iVlaintenance-ANNUAL � Piaces of Assembly-ANt1ttAL
<br /> � em `A�Tn r
<br /> Sprinkier � � G� CI ❑ � Rscreetionai 8um J�j��
<br /> Pite Alarm � Cl Cl d &pa�rklets r f
<br /> Hood Cleaning � ❑ p ❑ � Sprinkler System fnstallations �,
<br /> Hoad Suppression a C7 t� C � Standplpes{SprinklerSys}
<br /> � Fire Alarrn Instalistlon � Tarch Rooflng/TarKettie
<br /> QKire f'urnps � tMaste 7ire SEorage A�1NUAl
<br /> � �1re WotkS
<br /> � Ftammable Applic8tion-ANNUAL r�� �� Valuation of Proje�t
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<br /> �usi TEnkB
<br /> [� Other:
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<br /> Conlractar Com an � ��
<br /> 3ignature Etegistered Y t(tt Fee Gurrent Y!N
<br /> Address License#
<br /> EE.�Gif21GlAN Gompany
<br /> Signature Registered Y,/N� Fee Current Y/N
<br /> Addrass L"tcense#
<br /> PLUMBER • Company
<br /> 3ignaNte Reg�siered Y/N Fae Current Y 1 N
<br /> Address License#
<br /> MEGHANECAt Gampaay �� ��
<br /> Signature Registered Y/N Fee Curr�nt Y/N
<br /> Address License#
<br /> OTHER Campany
<br /> Slgnature �teg�stered Y!N Fe6 CURORi Y 1 fti!
<br /> Address License#
<br /> Oirections: ,.. ... . . ._ . ... _..� .-- , . . - . -. . . __ -, .- ,..�_.._ . . �. .. . ,._ ...,_....._..� .,., .._ _ - ._. �. ,,.. ,_ .
<br /> Fii aut apptication comptete4y.
<br /> C7wner&Contrador sign back of application,notarized(Rr,copy ot igned canUact wilh ovunerj
<br /> t€over$2500,a Naiiee af Comrr3eneement Is raquired{Mechanieal rk over�500Q)
<br /> Suppiy twa(2}seis of drswings with applicabie dacumerriation
<br /> Allqw 10-14 days for reviewakersubmlttal date. Pa ce1#-obtalned from Propeny Tax Ntatice(httpJlappraiser.pascogov.com)
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