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81F-780-0020 City of.ZephyrhillsFire• Fax - 1313-780 -0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> Owners Name tJA L l44fr /7 4.9 ?0 C, �, `, Owners Phone Number <br /> Owner's Address �74, 31 64-0- /J L v'© le- 1r( "Y 7 (J /( <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address 2$36iFi ThiNtrZ iika & * m Y ,w <br /> LOt# <br /> Job Address <br /> Sub Division Parcel # <br /> r Bio-Hazard Waste Storage - ANNUAL Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct 1 1 Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I I - Controlled Burn 1 1 Hood Installation <br /> 1 - 1 Emergency Generator < 30 kw 7 LP /Natural Gas - Installation <br /> Emergency Generator> 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL 1 Places of Assembly- ANNUAL <br /> Lltrly ) Semi I FUT 1 I Uther 1 <br /> Sprinkler ❑ ❑ 1 Recreational Bum <br /> Fire Alarm ❑` ❑ ❑ I 1 1 1 Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ 1 1 1 I Sprinkler System installations <br /> Hood Suppression f 1 ❑ ❑ ❑ I 1 1 1 Standpipes (Sprinkler Sys) <br /> 1 Fire Alarm Installation 1' 1 Torch Roofing/Tar Kettle <br /> Fire Pumps FT Waste Tire Storage ANNUAL <br /> El Fire Works <br /> Flammable Application- ANNUAL of Project <br /> Fuel Tanks <br /> 1-1 Other: 1 <br /> Contractor , Company . <br /> Signature Registered Y / N Fee Current I Y / N j <br /> Address 1 1 License # I <br /> ELECTRICIAN Company <br /> Signature Registered Y / N Fee Current I Y / N <br /> Address I License # <br /> PLUMBER Company <br /> Signature Registered Y / N j Fee Current Y / N <br /> Address License # 1 I <br /> MECHANICAL Company <br /> Signature Registered Y / N _ Fee Current I Y / N <br /> Address License # 1 <br /> OTHER Company <br /> Signature Registered Y / N Fee Current I Y / N I <br /> Address 1 License # <br /> M . .._ _._.;... - " '-" = ."rc't . '''' -' . , .A - _ _ _ _ y . ... -- - -. . rv. '.--- -.. <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 (httpilappraiser.pascogov.com) <br />