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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit _5 <br /> Owner's Name UN or- -2_0H-Y1LH10­-T Own.ers Phone Number <br /> Owners Address F <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> 7 <br /> Job Address 11333-5 554+ 5-—((Z457-0—T_ Lot# <br /> Sub Division Parcel# <br /> Bio-Hazard Waste Storage-ANNUAL Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier 11 or RQ Facility)ANNUAL <br /> Controlled Burn Hood Installation <br /> Emergency Generator<30 kw LP/Natural Gas-installation <br /> Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL <br /> FDFrTy-1 FS-e7m, rA-59 Fffg <br /> Sprinkler F-1 El El 0 Recreational Burn <br /> Fire Alarm 1-1 El El 1-1 Sparklers <br /> Hood Cleaning F-1 0 El 0 Sprinkler System Installations <br /> Hood Suppression El 0 El 0 Standpipes(Sprinkler Sys) <br /> Fire Alarm Installation Torch Roofingfrar Kettle <br /> Fire Pumps Waste Tire Storage ANNUAL <br /> Flammable Application-ANNUAL C <br /> F7 q Lf 0,001 Valuation of Project <br /> Fuel Tanks <br /> Other: <br /> Contractor Company f:_1 A <br /> Signature Registered Y/N Fee Current Y/N 7' <br /> Address 1-31W 5+J1TE A,72IR P,4 151- License# 65 co—7 3 <br /> ELECTRICIAN Company <br /> Registered <br /> d Y/N Fee Current <br /> Address License# E_ <br /> PLUMBER Company I <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICALI Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# F_ <br /> OTHER Company I I <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 />