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813-780-0020 City of Zephyrhills Fire FaX-813-780-0021 <br /> Permit Application <br /> Date Received I Phone Contact for Permit <br /> Owner's Name Vc-& (s \—WOwnees Phone Number <br /> 7,!; .1 <br /> Owner's Address 5c) �2ti <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address L -::3S(44 lot# <br /> Parcel# Zr .-1Z('—*?—k -0000—Co\00— <br /> Sub Divislon f7ti Cod <br /> Blo-Hazard Waste Storage-ANNUAL M Fumigation Tent <br /> Comm Exhaust Kitchen HoodiDuct 0 Hazardous Material(Tier 11 or RO Facility)ANNUAL <br /> Controlled Bum F-1 Hood Installation <br /> Emergency Generator<30 kw I.PiNatural Gas-Installatior <br /> Emergency Generator>30 kw P LP/Natural Gas-ANNUAL Sale, <br /> Fire Protection Maintenance-ANNUAL F1 Places of Assembly-ANNUAL <br /> M MIME 9 or <br /> 13 Sprinkler r-1 0 0 ❑ 2 Recreational Bum <br /> Fire Alarm 0 0 1:03 = 0 <br /> El Sparklers t , <br /> Hood Cleaning H D 0 0 Sprinkler System Installations <br /> Hood Suppression 0 13 0 R R Standpipes(Sprinkler Sys) A9. 6 , <br /> IQFire Alarm Installation Torch Roofingrrar Kettle <br /> M Fire Pumps ED Waste Tire Storage ANNUAL <br /> HFlammable Application-ANNUAL Valuation O P OjeCt <br /> Fuel Tanks <br /> Other <br /> Contractor Company <br /> Signature Registered I YIN_J Fee Current I YIN <br /> Address I Mo-'50 5c)L,�& I)(- 9�t— '�,CD CX- License# I E-P— 2D 00 k 14 <br /> ELECTRICIANJ Company I <br /> Signature Registered Y I N I Fee Current <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fie current LY IN J <br /> Address License# <br /> MECHANICALI Company <br /> Signature Registered Y/N Fee current L_11�N - <br /> Address uoense# F- <br /> OTHER Company I <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$6000) <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-11appraiser.pescogov.com) <br />