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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received �. 11 77 Phone Contact for Permit <br /> Owner's Name 8►io4 L Owner's Phone Number 1� <br /> Owners Address 5 0 -�©� S� P9 414A33 6 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Add-reps 5 5 Z Lot# <br /> Sub Division Parcel# v 6 0 +d d do 3 <br /> Bio-Hazard Waste Storage-ANNUAL Fum(gation Tent. <br /> Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> Controlled Bum Hood Installation <br /> Emergency Generator<30 kw LP/Natural Gas-Installatior <br /> Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale <br /> 0 Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL <br /> ® em MI <br /> / jam► <br /> Sprinkler ❑ ❑ ElRebreationai Bum / / / <br /> f`% <br /> Fire Alarm ❑ ❑. ❑ El Sparklers r - <br /> Hood Cleaning ❑ ❑ ❑ C Sprinkler System Installations u� <br /> Hood Suppression El ❑ ❑ ❑ Standpipes(Sprinkler Sys) <br /> Fire Alarm Installation = Torch Roofinglrar Kettle <br /> Fire Pumps ED Waste Tire Storage.ANNUAL <br /> R <br /> Flammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Other: <br /> Contractor Company <br /> SignatureA Registered Y/N Fee Cu t -�Y/N <br /> Address 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 Campany <br /> Signature Registered Y/N Fee Current <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.appimation,not-dzed-(OY;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 10714 days for review after submittal date. 1 Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />