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$813 - 780 - 0020 City of Zephyrhills Fire ?)461 Fax - 813 - 780 - 0021 <br /> Permit Application <br /> Date Received 1 1 Phone Contact for Permit I 1 1 I <br /> Owner's Name 1 1 Iprid a & ye. core j CAtw ✓a c 1- (er ie Owner's Phone Number 1 1 <br /> Owner's Address 1 6 6r *U Blvd. <br /> Fee Simple Titleholder Name I Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> Job Address I Lot # <br /> Sub Division I Parcel # • <br /> n Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier 11 or RQ Facility) ANNUAL <br /> n Comm Exhaust Kitchen Hood /Duct El Hood Installation <br /> LJ Controlled Bum 1E1 LP /Natural Gas - Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale <br /> El Emergency Generator > 30 kw n Places of Assembly- ANNUAL <br /> E Fire Protection Maintenance - ANNUAL n Recreational Burn <br /> 741 <br /> J (Semi 03 Other <br /> S(101441eJ Sprinkler ❑ ❑ DC 0 Sparklers <br /> Vor 3 2S "04 Fire Alarm 0 ❑ ❑ ❑ ( 1 n Sprinkler System Installations <br /> Hood Cleaning n ❑ ❑ ❑ 1 1 n Standpipes (Sprinkler Sys) <br /> Hood Suppression ❑ ❑ ❑ ❑ 1 1 n Torch Roofing/Tar Kettle <br /> El Fire Alarm Installation n Waste Tire Storage ANNUAL <br /> E Fire Pumps <br /> Fire Works <br /> E Flammable Application- ANNUAL 1 ( Valuation of Project <br /> El Fuel Tanks <br /> 0 Other: I <br /> Contractor Company • L'ex Fee C y <br /> ,'. el <br /> Signature Registered KM Fee Current I MA <br /> Address 1 7910 Pro essiabial Pace , raw.pa FL I License# 016982L000139!? - . <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N I Fee Current L Y / N <br /> Address I License # I <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N <br /> Address ( 1 License # I I <br /> MECHANICAL Company <br /> Signature Registered Y / N 1 Fee Current 1 Y / N <br /> Address I I License # I I <br /> OTHER Company I <br /> Signature Registered Y/ N Fee Current I Y/ N <br /> Address I I License # ( <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 />