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813-780-0020 Clty ofZephyrhillsFire. Fax- 813 -7so -0021 .i; <br /> . Permit Application . �_ <br /> Daps Received ! - - Phone Contact Permit g 1 ; • 6 3 <br /> NIP <br /> Owner's Name l L — 13 e-S ck. 0. n 1 Owner's Phone Number I g 13 ] 17 g3 1 I 1 l ( ,- <br /> Owners Address 1 7o /{ 6c,_ /j LS Arlo <br /> Fee Simple Titleholder Name l Titleholder Phone Number l _ 1 1 I <br /> Fee Simple Titleholder Address ) 1 <br /> Job Address 1 ' 7 3o5 Gc.// PIA 1 Lot # i <br /> Sub DPviston 1 1 Parcel # ) <br /> 0 Bio- Hazard Waste Storage - .ANNUAL 17 Fumigation Tent <br /> ED • Comm Exhaust Kitchen Hood/Duct E3 Hazardous Material (Tier 11 orRQ Facility) ANNUAL <br /> n Controlled Bum = Hood Installation <br /> n Emergency Generator < 30 kw ni LPiNaturai Gas - Installation <br /> ED Emergency Generator> 30 kw n LPMabcral Gas - ANNUAL Sale <br /> ri Fire Protection Maintenance - ANNUAL = Places of Assembly- ANNUAL <br /> MI lsem11 rEn laliAlli � <br /> Sprinkler Ej ❑ ❑ ❑ I ('- Recreational Burn <br /> Ul , l I . 01 Fire Alarm ID ❑ f 1 ri Sparklers <br /> Hood Cleating ❑ ❑ ❑ l 16 a✓K I E Sprinker System Installations <br /> dSuppreaaiors ❑ ❑ - ❑ r !J <br /> l Standpipes (SprlNdarSys) <br /> n Fire Alarm installation a Torch Rooting/Ter Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application ANNUAL I ) Valuation of Project <br /> Fuel Tanks <br /> ED Other:. I <br /> n any Vea . - i. Do(.37 �.�r I <br /> Signature 1 r I (� ^ >� - Registered Y/ N 1 Fee Currant J Y/ N 1 <br /> Address I Cal rn 1 cle..0 I)l � +a- /7 1 License # <br /> ELECTRICIAN Comb I <br /> Signature Registered Y/ N I Fee Current 1 Y/ N I <br /> Address 1 1 License # I 1 <br /> PLUMBER Company 1 <br /> Signature , Registered Y / N Fee Current ( Y PSI. I <br /> Address 1 1 License# I <br /> MECHANICAL Company . J <br /> Signature Registered Y/ N Fee Current I Y/ N f <br /> Address 1 I .. - License I - 1 <br /> OTHER r Company 1 <br /> Signature I Registered I Y/ N 1 Fee Current ` Y / N I <br /> Address 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 le 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. Para! #- obtained torn Property Tax Notice (hti llappraiser pascogov.com) <br />