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813-780-0020 City of Zephyrhills Fite Fax-813-780-0021 <br /> J Permit Application <br /> Date Received CoPhone Contact for Permit <br /> Owner's Name W Epor�-0 n Owner's Phone Number <br /> Owner's Address � 7( S5iDI1Gi( C@hA-fY br,Sle t/00 FaJ0 /', h 6Af-ele!?5 t (, 34 0 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address 75TD Ga �rh r tS rL,m 335+2- _ Lot# <br /> Sub Division Parcel# <br /> Bio-Hazard Waste Storage-ANNUAL Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct - Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> Controlled Bum Hood Installation <br /> 0 Emergency Generator<30.kw LP/Natural Gas-Installation ^ L�3 <br /> Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale ` l <br /> Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL <br /> ®y emi E er , <br /> Sprinkler ❑ ❑ ❑ Recreational Bum ��� n�ir(-�/ 2—av <br /> Fire Alarm ❑ ❑ ❑ Sparklers n <br /> Hood Cleaning ❑ ❑ ❑ El Sprinkler System Installations v I e V, L-rs - {` <br /> Hood Suppression ❑ ❑ ❑ ❑ Standpipes(Sprinkler Sys) <br /> Fire Alarm Installation ,Torch Roofing/Tar Kettle, <br /> Fire Pumps "' E�(] Waste Tire Storage ANNUAL <br /> Flammable Application-ANNUAL Valuation of Project <br /> .—Fuel--Tanks- . <br /> Q Other: <br /> Contractor Company <br /> Signature F Registered Y/N Fee Current Y/N <br /> Address I License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N 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 Y/N Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <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(Mechanical 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(http://appraiser.pascogov.com) <br />