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' / 8 (V Fax-813-780-0091 <br /> City of ZephyrhillsFire• a <br /> 81 7so -oo2o Permit Application 1 <br /> . - Phone Contact for Permit I 1 <br /> Dat.. Received — �� 1 1 � <br /> �,::.sr�._..._ .,,...�w...,� :.- .......,._ . .. axe C .._....._ <br /> Owners Phone Number , �g 1 <br /> - <br /> Owner's Name ®:` .r ' i,,��� j .2 <br /> _ Owner's Address <br /> Titleholder Phone Number 1 <br /> Fee Simple Titleholder Name <br /> Fee Simple Titleholder Address I Fr, w .,... ik ; � Y ��4 r°3s w ...x k.. . s :, x <br /> 1 <br /> . N..,... a .:. 61-12-Q- ` ) t T� L ot # 1 <br /> ` i _ . ( <br /> . <br /> Job Address <br /> Parcel #�. <br /> Sub Division -•° "'��°" <br /> Bio-Hazard Waste Storage - ANNUAL <br /> Fumigation Tent <br /> Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Comm Exhaust Kitchen Hood /Duct <br /> Hood installation <br /> - Controlled Sum 1. I <br /> 71 LP /Natural Gas - installation <br /> Emergency Generator < 30 kw I I LP/Natural Gas - ANNUAL Sale <br /> 1 1 Fire Generator 30 - - 1--- laces of Assembly- ANNUAL <br /> 1 Fire Protection tion Mainten enance = AN utrl � - v i Utner - J \/I <br /> Sprinkler <br /> 0 0 0 7 Recreational Burn <br /> Fire Alarm <br /> 0 0 0 1 1 1 Sparklers <br /> Hood Cleaning <br /> D 9 1 Sprinkler System Installations <br /> j 0 ED 0 Standpipes (Sprinkler Sys) <br /> Hood Suppression J 1 <br /> Fire Alarm Installation <br /> 1 Torch Roofing/Tar Kettle <br /> ( <br /> I Waste Tire Storage ANNUAL <br /> Fire Pumps � <br /> I i Fire Works Valuation of Project <br /> 1 Flammable Application- ANNUAL <br /> I I Fuel Tanks <br /> 1 Other: 1 <br /> Company <br /> Contractor � <br /> Signature ,C I Registered Y / N 1 Fee Current 1 Y / N <br /> I I <br /> License # <br /> Address 1 ' <br /> I <br /> ELECTRICIAN Company <br /> Registered Y / N 1 Fee Current 1 Y / N 1 <br /> Signature I <br /> Address I 1 License # <br /> l Company <br /> PLUMBER Registered Y/ N 1 Fee Current L Y / N <br /> Signature � <br /> Address 1 1 License # <br /> Company <br /> MECHANICAL 1 Fee Current 1 Y / N <br /> !I Registered Y / N <br /> Signature 1 <br /> Address 1 1 -License* <br /> OTHER 1 1 Company <br /> Registered Y / N 1 Fee Current I Y / N <br /> Signature <br /> License # <br /> Address FP:-< �r., ,: ,.m _.�.;: -;. <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 /> • <br />