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813 -78O -0020 City ofZephyrhillsFire- Fax - 813-780 -0021 <br /> Permit Application <br /> Date Received <br /> Permit <br /> Owner's Name ZC /) y e I.: `!S OA t•• eb Owner's Phone Number <br /> 8V115 -J j t }- <br /> Owner's Address b � / �'r Q � V �/ Z,e�� y r ;AM S I r C <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> :T „.e 1' A LX }7J' PVkwk ate i <br /> ...: �.. �,... '�re. "?' t.mzwb�u; ' w «.,.. ' ' �f .� ,.. »:..,: :.0 .., i. _ ..:,.. . ”. rNN„ I':% �'. �t�. �Ffi%:. Sr .°i,.u'�':r .,. ,.,�,a ..n.�w...,. v.,........F�r . ..a.,: .�. u.-..r .,...,...«.� ,,. .. ,. <br /> Lot* <br /> Job Address <br /> Sub Division - <br /> Parcel <br /> IT Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n - Controlled Burn 1 Hood installation <br /> Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> I Emergency Generator> 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL I I Places of Assembly- ANNUAL <br /> J L.ttrlyl JSemi I pZ71 'Littler : 6 Z <br /> Sprinkler n ❑ ❑ ID Recreational Bum 1 <br /> Fire Alarm ---7 ❑ ❑ 2(J Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ J Sprinkler System Installations <br /> Hood Suppression I ❑ ❑ ❑ J J Standpipes (Sprinkler Sys) <br /> f] Fire Alarm Installation I' Torch Roofing/Tar Kettle <br /> Fire Pumps I Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL Valuation of Project <br /> Fuel Tanks <br /> n Other: I <br /> Contractor i t Company <br /> Signature <br /> jt ( Registered _ Y / N Fee Current I Y / N <br /> Address 1 1 License* 1 <br /> ELECTRICIAN Company <br /> Signature Registered _ Y / N Fee Current Y / N - <br /> Address I License # <br /> PLUMBER Company <br /> Signature Registered Y / N Fee Current Y / N I <br /> Address I I License* 1 <br /> MECHANICAL Company <br /> Signature Registered - Y / N Fee Current 1 Y / N <br /> Address 1 • License # I <br /> OTHER, Company <br /> Signature Registered Y / N Fee Current 1 Y / N <br /> Address License # I <br /> , e s,,, ..,am.. - ..... Dam <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 ft- obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br />