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813 -7F J -0020 City of Zephyrhills Fire Fax - 813-780 -0021 <br /> Permit Application <br /> Date Received I Phone Contact for Permit I I J <br /> ' Owner's Name 1 , A Ppi A- t ( il r t-LC c. - Owner's Phone Number <br /> /Owner's Address 009 Coil- � ( i voe <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> /Job Address �� ' .P P PO Lot# <br /> Sub Division Joo' K, P1 Vd Parcel # <br /> ter_ . . •::.. N ...::: + _ -,., . ..: .. .. .....: .. =,,,„ mip :m ... a aa, n , <br /> pi Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> I Comm Exhaust Kitchen Hood /Duct I 1 Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I Controlled Bum 1 Hood Installation <br /> f --- I Emergency Generator < 30 kw I LP /Natural Gas - installation <br /> I Emergency Generator> 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> I Fire Protection Maintenance - ANNUAL I Places of Assembly- ANNUAL <br /> IUtriy1 ISemiI J iiil Other <br /> Sprinkler 7 ❑ ❑ ❑ I Recreational Bum <br /> Fire Alarm I ❑ ❑ ❑ 1 1 Ii Sparklers <br /> Hood Cleaning I ❑ ❑ ,! ❑ I I I] Sprinkler System Installations <br /> Hood Suppression F❑ ld" ❑ I I I Standpipes (Sprinkler Sys) <br /> I] Fire Alarm Installation I Torch Roofing/Tar Kettle <br /> I I Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> 7 Flammable Application- ANNUAL 1 I Valuation of Project <br /> I Fuel Tanks <br /> ( Other: I I <br /> t.U: .. nW ... . ; . ..U.e..,....; a' §. . u£2�, . '..,......,_...a�,.�"d?,:: .s.�..,. a.?,-- ....,. ys, ' 5' .... .,.0 . v ,,.:.V_.o...a ?�i at a. . . «. ...: s ..0 2.`...-: <br /> Contractor it ` Company 1. T /- rC a C, i c (1 it <br /> Signature y'' (� Registered Y / N j Fee Current I Y / N 1 <br /> Address I 66 ( License # ( I <br /> ELECTRICIAN Company <br /> Signature Registered Y / N I Fee Current I Y / N j <br /> Address I I License # I I <br /> PLUMBER Company I <br /> Signature Registered Y / N J Fee Current I Y / N <br /> Address I I License # <br /> MECHANICAL Company I <br /> Signature Registered Y/ N I Fee Current I Y / N I <br /> Address I I License # I <br /> OTHER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I License # J I <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 />