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813- 780 -0020 City of Zephyrhills Fire- Fax-813-780-0021 ,. <br /> Permit Application - it <br /> Date Received Contact for Pernit I I <br /> Owners Name I <br /> c � r �S I Owners Phone Number [my! I --no I tit* i <br /> Owners Address I "1i ) Cam cl t)& 7,0 VAe4:As , cl... 1 <br /> Fee Simple Titleholder Name 1 I Titleholder Phone Number I 11 11 1 <br /> Fee Simple Titleholder Address I I <br /> Job Address 1 I Lot # I <br /> Sub Division 1 ( Parcel it 1 I <br /> 0 Bio- Hazard Waste Storage - ANNUAL Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct ICI Hazardous Material (Tier 11 or RQ Faci ity) ANNUAL <br /> 0 Controlled Bum n Hood Installation <br /> ED Emergency Generator < 30 kw ED LP/Natural Gas-Installation <br /> El Emergency Generator> 30 kw r1 LP/Nahrrel Gas - ANNUAL Sale <br /> ED Fire Protection Maintenance - ANNUAL • = Places of Assembly- ANNUAL <br /> ®I l Erl <br /> Sprinkler LI ❑ ❑ ❑ Q Renal Burn <br /> Fire Alarm ❑ ❑ ❑ I 1 El Sparkler's <br /> Hood Cleaning )11. ❑ ❑ ( , El Spy System t <br /> Hood Suppression ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> ri Fire Alarm installation = Torch Roofing/Tar Kettle <br /> Fire Pumps a Waste The Storage ANNUAL <br /> Fire works <br /> Flammable Application ANNUAL I I Valuation of Project <br /> FueI Tanks <br /> �A .1...„_ 3 <br /> Contractor O,� � t i� M ` Y / N ' Fee Current I Y / N I <br /> Signature -11A �_ ►.� , w r <br /> Address we ti . - l k, _ + j License # I 1 • <br /> ELECTRIC Y <br /> Signature Registered I Y/ N I Fee Current I YIN 1 <br /> Address 1 1 License # I I <br /> PLUMBER Company l <br /> Signature Registered J Y / N I Fee Current I Y / N I <br /> Address I I License # I I <br /> MECHANICAL I Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I 1 # I 1 <br /> OTHER <br /> Signature I I Regist I Y/ N I Fee Current I Y/ N I ComPanY <br /> Address <br /> 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 / /appreiser.pascogov.com) <br /> • <br />