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� 813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received 3 P � Phone Contact for Permit T�_���_� <br /> �-�_�_,.�.!-��_..._w..w�,......._�....�,_.__��__.�...�. -�-���:-x._,.;�zyz;��-.....�-�� - -...�-,._�....w..-�,..._.,�:N.�� :.._._ , ._.e... _. _...: <br /> Owners Name �/�'� � (,!%� �l� � �++ners Phone Number r_� � � <br /> Owner's Address �p �33 - ��(,C� L� <br /> Fee Simple Titleholder Name Titleholder Phone Number � O � <br /> Fee Simple Titleholder Address ' <br /> C:`.._"�'.''�-^,'�;'�'ys�'-,^�''.�'�'*•"�;^ - - - ' '��._YE.,�=r'"'°`:�:�.`:`'.��:"` -_c�_..�K�y„�.:s-_- .,,. -. ,.�_,_:e__=:�_��..�""`z�'..,"`-��.r„�.,__'z`��"T�":' <br /> Job Address 3 g 33� �(,QJ ��- s ��7 ��'�.6.,(--� L� v Lot# '-- � <br /> Sub Division Parcel# <br /> (y`�.."-r�.��.r,,:�7.:;�ak.i•`.:;,i�..::�7""3:�"�.�-�.�."-�_'�`:?=;ti'�.....__.�<��.;..- �._��.�,.�...:.....�...:s>1—_a!•Nx-`-..�..��;u`.^..'�-..';r: -" �..._..�.,�,..«_.�i...�.�:t,�s`^�.:>�i w-..r.....,:......:.-��''.�s,'-_'.'��.-`.�'a«....,,.�.�...r...�,.......e�^`�:.-`".�.�.-�-�a".c'%a <br /> � Bio-Hazard Waste Storage-ANNUAL W� Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � � Controlled Bum � Hood Installation _� <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � L atural Gas-ANIdUAL Sale <br /> Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL <br /> 0 <br /> �y emi �n er <br /> � <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum <br /> Fire Alarm_ � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ , ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch RoofinglTar Kettle � <br /> � � Waste Tire Storage ANNUAL /� , <br /> Fire Pumps <br /> v <br /> � Flammable Application-ANtdUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> ,_�,.-�-___.-�-._.�_.,�;_..�.r __�-_.,_. . - - - � - �--=-;���--�r------_. <br /> ..., _,��._...__�.�:.�,�.-.� <br /> .:_.,«�. ...-.�.�,.�.,.u.,,�.�.,�V,.,� <br /> r_. w,x.a�� �.�:... _, _",�s:::t...ws._�,._._=..�u____..�.�,�.�.-�....�.. .�.__._�:�.s�,...u, - _�._..�..._....�..- _�..:.__ __:::._.�_ �_�. <br /> Contractor Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered l�/nl Fee Current Y/N <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature • Registered l�/1� Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> 4. _ - '�L�:S�.--�_..1..x.�....1.i__�...`..:.`_«...i,..S.��.�.:S4�t..._�_._,..�.....+�.:T.�.�..e.�_.r���..1.7s.x.�.,_,..✓�.�.v�.__......-4..._.:...+�.,..;.-��..-_:-::�`.:n„_�...w_-�..�_r.....�Y,.a_-.,r,4....�........_:.2'�....' _.���«�i-'�i`:�:� <br /> ......... .... .. . ... :» ..• -, .,. .r-r..:. - .:... � - <br /> ',2.�,s'..x_ I <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(AAechanical work over$5000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(httpJ/appraiser.pascogov.com) <br />