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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 <br /> Owner's Name Pr ti 69.— C"-t —S C, Owners Phone Number <br /> Owner's Address <br /> Y- :EJ- 33 ,� o -76 o(z I <br /> Fee Simple Titleholder Name Titleholder Phone Number �� L� <br /> Fee Simple Titleholder Address <br /> HVVEMV,W-03�-i <br /> Job Address 6—,JA Blvcl I Lot# <br /> + <br /> Sub Division Parcel# <br /> F-1 Bio-Hazard Waste Storage-ANNUAL Fumigation Tent <br /> F� Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier It or RQ Facility)ANNUAL <br /> F-1 Controlled Bum a Hood Installation <br /> = Emergency Generator<30 kw, LPINatural Gas-Installatior <br /> F-1 Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL <br /> Mtyl We—ml, An FOthers/--1 <br /> Sprinkler F-1 0 0 0 ❑ Recreational Bum <br /> Fire Alarm F-1 0 0 0 F-1 Sparklers <br /> Hood Cleaning F-1 0 0 El Sprinkler System Installations <br /> Hood Suppression El 11 0 0 Standpipes(Sprinkler Sys) <br /> Fire Alarm Installation o Torch Roofingfrar Kettle <br /> F-1 Fire Pumps Waste Tire Storage ANNUAL <br /> RFlammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> F-1 Other: <br /> Contractor Company <br /> Signature F C4 Registered Y/N Fee Current 77—N <br /> Address License# <br /> ELECTRICIANI Company <br /> Signature Registered Y/N Fee Current L_Y/N <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered YIN Fee Current L_.y I N J <br /> Address License# <br /> MECHANICALI Company <br /> Signature Registered Y/N Fee Current <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current <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 />