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813 -780 -0020 City of Zephyrhills fife. Fax- 813 -780 -0021 <br /> Permit Application _ .. <br /> Date Received 1 I - Phone Contact for Permit <br /> Owners Name I AletS7 /,A/ ftsi / 64,e 1 Owner's Phone Number 111 1 1 2F2 11 s7 <br /> Owners Address 1„34 .. Sa AK' Z'fr Vi-h//..f. <br /> ,//..f 1 • <br /> Fee Simple Titleholder Name I I Titleholder Phone Number I 1 1 1 1 <br /> Fee Simple Titleholder Address I <br /> ,-, ,.x .. .n _ .x ... � ._ <br /> Job Address 1 Lot # I <br /> Sub Division 1 Parcel # <br /> a Bio- Haiard Waste Storage - ANNUAL n Fumigation Tent <br /> El Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> E Controlled Bum n Hood Installation <br /> a Emergency Generator < 30 kw n LPINattuaI Gas - Installation <br /> CI Emergency Generator > 30 kw n LP/Natural Gas - ANNUAL Sale <br /> ED Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> ® r ®txtrer <br /> Sprinker Li ❑ ❑ ❑ ( n Recreational Burn <br /> Fire Alarm n ❑ 0 ❑ I I n Sparklers <br /> Hood Clearing El ❑ ❑ ❑ I ri Sprinkler System Installations <br /> . Hood Suppression S ❑ A ❑ I I Standpipes (Sprinkler Sys) <br /> E Fire Alarm Installation o Torch Roofing/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL ' l Valuation of Project <br /> Fuel Tanks <br /> 0 Other <br /> Contractor Company I <br /> Signature Registered Y/ N I Fee Current I YIN I <br /> Address I License # <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N I Fee Current 1 Y/ N - I <br /> Address I License # I <br /> PLUMBER Company I <br /> Signature Registered Y / N I Fee Ctxrent I Y/ N J <br /> Address I I License # I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N J Fee Current I Y/ N I <br /> Address I I License # I <br /> OTHER . Company L <br /> Signature `" 7 .�G'[. -- Registered Fee Current <br /> Address '` � ifirarAFAIWNAMIE License # j e ""- ©06 ( • <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 (httpJ/appraiser.pascogov.c om) <br />