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813- 780 -0020 City of Zephyrhills•Fire Fax- 813 - 780 -0021 <br /> Permit Application 4 <br /> )ate Received W - Phone Contact for Permit <br /> »4 !:� . s:. - •:try. •e r . _ , r r .r,... ..,�. <br /> )wner's Name d re ►.. , P. .... Owner's Phone Number 1 I l <br /> ■ 1 _ - <br /> ) )wner's Address I LI (t) y S. t o c a c T P- & 7-pp 1 a k.. t t , a' s a s -1 • <br /> =ee Simple Titleholder Name Titleholder Phone Number 1Y1 1 997 I 61 5 <br /> zee Simple Titleholder Address <br /> Job Address (j L .■ r . L -, it r, ( i 3 35 Lot # <br /> Sub Division Parcel # <br /> I <br /> Bb- Hazard Waste Storage - ANNUAL a Fumigation Tent <br /> ED Comm Exhaust Kitchen Hood/Duct I f Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum Hood Installation <br /> r -- 1 Emergency Generator < 30 kw 1 LP /Natural Gas - Installation <br /> Emergency Generator> 30 kw ( I LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL = Places of.Assembly- ANNUAL <br /> P mr raj tither <br /> Sprinkler /1 ❑ ❑ n Recreational Bum <br /> Fire Alarm ❑ ❑ I 1 7 Sparklers <br /> Hood Cleaning ❑ ❑ ❑ I I El Sprinkler System Installations <br /> Hood Suppression El ❑ ❑ ❑ I ) n Standpipes (Sprinkler Sys) <br /> ED Fire Alarm Installation I Torch- Roofing/Tar Kettle <br /> IN <br /> Fire Pumps ri Waste Tire Storage ANNUAL <br /> 1 Fire Works • <br /> Flammable Application- ANNUAL Valuation of Project <br /> Fuel Tanks <br /> I—I Other. <br /> ---. 11:-.Z7) <br /> Signature Company �� >!3� 1 5 <br /> g Registered Y/ N Fee Current Y / N <br /> Address (' 'r L:,-, f License* Ef 600 (D' - -7n I <br /> ELECTRICIAN Company <br /> Signature Registered Y / N Fee Current Y / N <br /> Address I I License # I <br /> PLUMBER Company <br /> Signature Registered Y / N e Current Y / N <br /> Address I I License # I <br /> MECHANICAL Company <br /> Signature Registered Y / N _I Fee Current 1 Y / N 1 <br /> Address 1 I License # <br /> OTHER <br /> Company <br /> Signature <br /> Registered Y / N Fee Current Y / N <br /> Address License it <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> If over S2500, 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 It - obtained from Property Tax Notice (Mtp:! /appraiser.pascogov.com) <br />