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813 -780 -0020 City of Zephyrhills Fire Fax- 813 - 780 -0021 <br /> Permit Application <br /> Date Received J I ,21 D U q Phone Contact for Permit J i B <br /> Owner's Name I Owner's Phone Number 1 1 1 I I* <br /> Owner's Address S ‘_c,// E, Vai <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> .... a . a.. ', .' Z.. M5V t t.rq'. a^ i.Z;;t ere a�".a's VRDYVMF.: s �* .- . ai .$.":; ' ;',EaFg . � F...s , .a.W k.... � d :F, : - ... . °? � . ET,.. !t .t:...... .. , sa s <br /> c / �7 / I r �5, �„ <br /> Job Address - £ s O a ck i' B )VII z.e. P 1 h p �,' JJ 5 (1 1 - 3 35' `/O Lot # <br /> Sub Division Parcel # <br /> I Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> I I Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> El Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> ni Fire Protection Maintenance - ANNUAL I I Places of Assembly- ANNUAL <br /> (GtMyI ISemil Vaii Uther <br /> Sprinkler ❑ ❑ ❑ n Recreational Bum /�/ Vi( <br /> Fire Alarm n ❑ ❑ ❑ I I I I Sparklers U —,3 <br /> Hood Cleaning ❑ ❑ ❑ I I n Sprinkler System Installations —^'— <br /> Hood Suppression ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> 7 Fire Pumps n Waste Tire Storage ANNUAL <br /> II Fire Works <br /> Flammable Application- ANNUAL I I Valuation of Project <br /> I Fuel Tanks <br /> I—I Other: I _ <br /> <ian.. i.. .._:��^ ...:' e'.ust't"".«�,�eaagarg .: .I .O.Ws. . s'^',1 ?. � "m;- :1 M 'MEXPAW. 'MCNk' .,>x.,....:iggi2M . ua... si u'. aMMTIMM £; �'a Pd kWATai ".'a l <br /> Contractor ��f / Company V ig ce (-CC e� A r , c 1 S" I <br /> Signature Registered N I Fee Current Y / <br /> Address I M Zd M ✓/n r d r M, R- 3 - <br /> 2 7r I License # I <br /> ELECTRICIAN F <br /> Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address 1 I License # <br /> PLUMBER Company <br /> Signature Registered Y / N . 1 Fee Current I Y / N <br /> Address I I License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N j 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 j <br /> Address I License # 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 />