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813-780 -0020 City of Zephyrhills Fire Fax -813 -780 -0021 <br /> ■ _.--i ` Permit Application <br /> Date Received Phone Contact for Permit <br /> Owner's Name F f 4 T 8‘.40-4/L V- V j Owner's Phone Number g13 7/5 0 d 2 ) <br /> Owner's Address 7 , 9 (J-,4L ALL no Z EPHyt� I / Y FL 3 3 t/ <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple - Titleholder Address I <br /> Job Address / 7 4 7U9 C1',4& a f ) Z e p i t ( y L 1 - )/LL. , (- L 33S ( 1/ Lot# <br /> Sub Division Parcel # <br /> n Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> F-1 ° <br /> Controlled Bum I Hood Installation �. d/" <br /> Ti Emergency Generator < 30 kw ( I LP /Natural Gas - Installation /" <br /> Emergency Generator> 30 kw I LP /Natural Gas - ANNUAL Sale ‘1**1"T <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> I Litrlyl I Semi I Other <br /> Sprinkler n ❑ ❑ ❑ Recreational Bum ' / 6-- <br /> Fire Alarm n ❑ ❑ ❑ I I I Sparklers <br /> Hood Cleaning n ❑ 0 ❑ I L 1 Sprinkler System Installations <br /> Hood Suppression ' <br /> _ ❑ 9 ❑ I 1 I I Standpipes (Sprinkler Sys) <br /> �j q o <br /> I I Fire Alarm Installation n Torch Roofing/Tar Kettle J� / _) <br /> n Fire Pumps I Waste Tire Storage ANNUAL (/ <br /> n Fire Works <br /> Flammable Application- ANNUAL <br /> If ] Fuel Tanks <br /> n Other: I <br /> . ,.., . ..,....v. ., _4..::.. .... ,,,a . 1, ::: i,:i S ms ,,.. . tr':ia _...., .,t&,, , :M"tke: .....r.....1 ...... .lA.a. ... _ .. .,...._.M . ,: ti ASE ._ ; ,,a_ <br /> Contractor „: ... L / Company f filet 672(e/1-^( Pei 6 5 j tc' r/ I <br /> Signature / / / Registered Y / N 1 Fee Current 1 Y / N <br /> Address I I License # I <br /> ELECTRICIAN Company <br /> Signature Registered Y / N 1 Fee Current I Y / N <br /> Address I <br /> 1 License # <br /> PLUMBER Company I <br /> Signature Registered Y / N I Fee Current 1 Y/ N <br /> Address 1 I License # I <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address I <br /> 1 License # <br /> OTHER <br /> Company <br /> Signature Registered Y/ N I Fee Current I Y / N I <br /> Address I <br /> License # 1 <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 />