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• <br /> 813-780-0020 City ofZephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received I I _„ _:. .,., <br /> Phone Contact for Permit <br /> '� / ` / n ti 3 7S c [_(C' <br /> Owner's Name ��{ tt�. t ��t.r'!%.ii (.y� l'r r i ( i ( , ,1/ Owner's Phone Number ( <br /> IA �/ // I � 3 <br /> Owner's Address 1 ., / 13 G �� l e vC t r N , A 02' S C' > k, , �� L• I l k <br /> Name 1 Titleholder Phone Number <br /> Fee Simple Titleholder J <br /> Fee Simple Titleholder Address 1 xr x . •.az , <br /> ux ;i, , +.. ki :.: . . « ». ::v 4 r m +s, -;,m. s t .,; � .. �ss�:".., y. ,:.ffita. ..' ,Y <br /> Lot # <br /> Job Address <br /> Sub Division 1 <br /> Parcel <br /> 1 1 Bio- HazardWasteStorage - ANNUAL 1 Fumigation Tent <br /> I I Comm Exhaust Kitchen Hood /Duct 1 I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n - Controlled Bum 1 1 Hood installation <br /> Emergency Generator < 30 kw 1 1 LP /Natural Gas - Installation <br /> I I Emergency Generator> 30 kw I ( LP /Natural Gas - ANNUAL Sale <br /> I Fire Protection Maintenance - ANNUAL Fri 1 X Places of Assembly- ANNUAL <br /> )utrly1 'Jsemij Ititner I I <br /> Sprinkler n ❑ ❑ ❑ 1 I 1 Recreational Bum <br /> Fire Alarm 70 0 ❑ I 1 1 I Sparklers <br /> Hood Cleaning El ❑ ❑ ❑ 1 I 1 I Sprinkler System installations <br /> Hood Suppression 7 ❑ ❑ ❑ J 1 I I Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation 1 I Torch Roofing/Tar Kettle <br /> 1 I Fire Pumps I ( Waste Tire Storage ANNUAL <br /> n Fire Works <br /> I I Flammable Application- ANNUAL ! I Vaivation of Project <br /> Fuel Tanks <br /> 1 I Other: 1 .. „t.. <br /> Contractor Company . <br /> Signature : Registered <br /> ignature Registered Y / N Fee Current Y / N <br /> Address License # <br /> ELECTRICIAN Company • Signature Registered Y / N Fee Current Y / N <br /> Address License # I <br /> PLUMBER Company <br /> Signature <br /> Registered Y / N Fee Current Y / N <br /> Address 1 License # <br /> MECHANICAL Company <br /> Signature Registered _ Y / N Fee Current 1 Y / N <br /> Address I License # 1 <br /> OTHER Company <br /> Signature Registered Y / N Fee Current 1 Y / N <br /> Address license # 1 <br /> 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 #- obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br />