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— r ' 813-780 -0020 City of Zephyrhills Fire. 91 u 1 Fax -813- 780 -0021 • Permit Application Date Received . - - Phone Contact for Permit Owner's Name fl A d` fir' / 1 Or . if 1 ' • _ Owners Phone Number I I Owner's Address I Fee Simple Titleholder Name I Titleholder Phone Number I I Fee Simple Titleholder Address I IMISISSIESS Job Address 7‘3 / GA --46 8L-(6C Lot# Sub Division I Parcel # I El Bio- Hazardpaste Storage - ANNUAL n Fumigation Tent • I1 Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RC) Facility) ANNUAL El Controlled Bum n Hood Installation n Emergency Generator < 30 kw r LP /Natural Gas - Installation n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale El Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL 6t" r y ems C7ther Sprinkler n ❑ ❑ ❑ Recreational Bum /� Fire Alarm D ❑ ❑ ❑ n Sparklers y Hood Cleaning I—I ❑ ❑ . ❑ I I n Sprinkler System Installations Hood Suppression ❑ / ❑ I I n Standpipes (Sprinkler Sys) In Fire Alarm Installation = Torch Roofing/Tar Kettle In Fire Pumps . n Waste Tire Storage ANNUAL Fire Works Flammable Application- ANNUAL 1 Valuation of Project Fuel Tanks Q Other: 1 I Contractor �� ' /' Company 7,741y/i 6 , ,...- , I Signature � _ 4 , / / /��1�: /, • . _ / f Registered Y / N I Fee Current Y / N I Address AIWA . b + • .,„,L.!aa At License # I ELECTRICIA Company Signature Registered Y/ N I Fee Current I Y/ N I Address I I License # I PLUMBER Company I Signature Registered Y / N 1 Fee Current I Y/ N I Address I I License # I I MECHANICAL Company Signature Registered Y/ N 1 Fee Current I Y/ N I Address 1 I License # 1 I OTHER Company I Signature Registered Y/ N I Fee Current I Y/ N 1 Address I License # I Aingailmaaatailosaksima Directions: Fill out application completely. Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) If over $2500, a Notice of Commencement is required (Mechanical work over $5000) Supply two (2) sets of drawings with applicable documentation Allow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com)