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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 7 &Cqt P7 14 9-� <br /> Owners Name LR. Ma-r- Owners Phone Number E= <br /> Owner's Address I t .61 V r-> <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address t COA-11 R) I V D Lot# <br /> Sub Division Parcel# <br /> .RI M,RRO RERTZATMi 140010 E-*wm w <br /> F-1 Blo-Hazard Waste Storage-ANNUAL Fumigation Tent <br /> Mr"r73 Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier 11 or RO Facility)ANNUAL <br /> Controlled Bum Hood Installation <br /> F-1 Emergency Generator<30 kw LP/Natural Gas-Installatior <br /> 0 Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale <br /> 0 Fire Protection Maintenance-ANNUAL o Places of Assembly-ANNUAL <br /> M-Fryl Semi rA-n-ll Other-j <br /> Sprinkler F-1 0 0 0 Recreational Bum <br /> Fire Alarm F-1 0 0 0 El Sparklers <br /> Hood Cleaning 13 0 0 0 Sprinkler System Installations <br /> Hood Suppression 0 0 D F—] Standpipes(Sprinkler Sys) <br /> F-1 Fire Alarm Installation Torch Roofing/Tar Kettle <br /> F-1 Fire Pumps Waste Tire Storage ANNUAL <br /> RFlammable Application-ANNUAL <br /> Fuel Tanks <br /> F--j Other: <br /> r— <br /> Contracto ompany '�1,44F <br /> Signature YrN,,] Fee Current L Y/NJ-` <br /> Address License# <br /> ELECTRICIANI Company <br /> Signature Registered Y/N Fee Current <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y--/—NT— <br /> Address License# <br /> MECHANICALI Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current —Y <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 />