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313-750 -0020 City of.Zephyrhills 9531 Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received l I Phone Contact for Permit 8/3 17/2-- 33/9 <br /> 1 s. -tea uH. <br /> Owner's Name ,CAly 0>< ze k r `i/IA Owner's Phone Number <br /> Owner's Address 5 k # Z•p4.4A f/• 3.35 <br /> Fee Simple Titleholder Name I Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address - 500.2 /y ;e17 7 AV Zdr#7/414 P/ 335V2-514/ Lot # <br /> Sub Division I I Parcel # /._ .L .t 0000 04/9/0 0014 <br /> 1 I Bio -Hazard Waste Storage - ANNUAL I I Fumigation Tent <br /> I I Comm Exhaust Kitchen Hood /Duct Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Controlled Bum I I Hood Installation <br /> Emergency Generator < 30 kw I J LP /Natural Gas - Installation <br /> Emergency Generator> 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> F Fire Protection Maintenance - ANNUAL I I Places of Assembly- ANNUAL <br /> }Utrlyl lbemiI Frl (Other <br /> Sprinkler n ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm El ID ( I I Sparklers <br /> Hood Cleaning Fit ID ❑ ❑ ❑ I I Sprinkler System Installations <br /> Hood Suppression C ❑ ❑ ❑ ) I I I Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation Roofing/Tar Kettle <br /> Rt � rss� s / � eer4 �'�''► � � TorchRoofin g <br /> I I Fire Pumps /#5 Per "tie M44 I I Waste Tire Storage ANNUAL <br /> l l Fire Works / crry <br /> 7 Flammable Application- ANNUAL J 4)2eo." Miff I Valuation of Project <br /> I I Fuel Tanks <br /> n Other: ( . 1.�a �z ... _ ��.. �. -�x. .. � _ -. <br /> ,., ti:a <br /> Contractor _ Company <br /> Signature Registered Y / N Fee Current Y / N <br /> Address I License # <br /> ELECTRICIAN Company / 7 h <br /> /e€'€ <br /> Signature It' ' ' • Registered ✓ � r f . N Fee Current Y N <br /> Address ,34i// /' # I / Zco r /7/5 F/ 373-1/0 License# EC - 0.00/Z42 <br /> PLUMBER Company <br /> Signature Registered Y / N Fee Current Y / N <br /> Address I License # <br /> MECHANICAL Company I <br /> Signature Registered Y / N Fee Current 1 Y / N <br /> Address I 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 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 />