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813-780 -0020 City ofZephyrhills "Fire• C Of( Fax - 813- 780-0021 <br /> Permit Application . . <br /> Date Received Phone Contact for Permit <br /> .,., .,:K�a e,„ x•.,. .- e+,�..- ..w,.w.vwxi «n.,�.:w. -- nee -.w. .- .rxM «.> ._.. ,., s w _ s.., . -mc, ,_. 4,, :•.x.m.,�= ss�.rw+%`'.`t£aa '"_'.w.� ,.__,.,,.e� aw.mwaa4,� <br /> Owner's Name 1 G % IeVAJtO Owners Phone Number = I '$ J 1 S2, <br /> Owners Address r Co&Q -Q `Gko& 7.4' ? \Ai4 \.kk4 N L. I <br /> Fee Simple Titleholder Name f Tltieholder Phone Number f I I <br /> Fee Simple - Titleholder Address <br /> „ , - , , , ,. .. .= i , - . t. -:.:, - g 5 - = . > -. w <A . *..,.x ?,.:..t. .... �; -. _.,a* ..-= ;=u . c - _ , 44..4-- Vo: <br /> Job Address Lot # <br /> Sub Division I I Parcel # I <br /> 0 Bio- Hazard Waste Storage - ANNUAL I I Fumigation Tent <br /> n Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier 11 or RQ Facility) ANNUAL <br /> nl Controlled Bum a Hood Installation <br /> n Emergency Generator < 30 kw FT LP/Natural Gas - Installation <br /> n Emergency Generator > 30 kw 1 � ! LP/Nat ral Gas - ANNUAL Safe <br /> L <br /> ED Fire Protection Maintenance - ANNUAL J ( Places of Assembly- ANNUAL <br /> a;yin IM1 ED Littler <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I I I I Sparklers <br /> Hood Cleaning 5C.. ❑ ❑ I 1 1 1 Sprinkler System Installations <br /> Hood Suppression M /❑ ❑ ❑ I ( I Standpipes (Sprinkler Sys) <br /> ED Fire Alarm Installation I I Torch Roofing/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application ANNUAL 1 , Valuation of Project <br /> Fuel Tanks <br /> a er. I <br /> Contractor ,. Company <br /> Signature �y ` ` i Registered Y / N 1 Fee Current I Y / N I <br /> Address I 4? c I` VG-L k G@ W Y\'4 .Cc:L Z J .3 License # I <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N I Fee Current 1 Y/ N <br /> Address I 1 License # I I <br /> PLUMBER Cony I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N 1 Fee Current I Y/ N I <br /> Address I I license # I <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <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 55000) <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 (httpJ /appraiser.pascogov.com) <br />