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813- 780 -0020 City of Zephyrhills Fire Fax- 813- 780 -0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> Owner's Name I ,Z` /2 1 P kif4.edx// 4. 0 E I Owner's Phone Number I I I <br /> Owner's Address I TO ) A 7W 57 <br /> Fee Simple Titleholder Name I I Titleholder Phone Number I I <br /> Fee Simple Titleholder Address I <br /> Job Address Lot # I <br /> Sub Division I I Parcel # <br /> s <br /> E Bio-Hazard Waste Storage - ANNUAL El Hazardous Material (Tier II or RQ Facility) ANNUAL . <br /> E Comm Exhaust Kitchen Hood /Duct n Hood Installation <br /> Controlled Bum = LP /Natural Gas - Installation <br /> Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale <br /> El Emergency Generator> 30 kw n Places of Assembly-ANNUAL <br /> El Fire Protection Maintenance - ANNUAL = Recreational Bum <br /> Sprinkler 0 ❑ ❑ ❑ D Sparklers <br /> Fire Alami 0 ❑ ❑ ❑ I I [] Sprinkler System Installations <br /> Hood Cleaning El ❑ ❑ ❑ I I El Standpipes (Sprinkler Sys) <br /> Hood Suppression 0 ❑ ❑ ❑ I I = Torch Roofing/Tar Kettle <br /> Fire Alarm Installation = Waste Tire Storage ANNUAL <br /> Fire Pumps <br /> Fire Works <br /> Flammable Application- ANNUAL 1 Valuation of Project <br /> Fuel Tanks <br /> 0 Other: I I <br /> -&°� I�,:i is.*�.;�sFa£ .t;n„r.. , r:. r, ��tr^; ++a..wps ': ,.�s s%.":�*:&,ra. '#Y�a ±M2at,.= :��� :;r.,' <br /> Contractor Company I <br /> Signature ,„Q L i' 1( Registered Y/ N _1 Fee Current I Y/ N I <br /> Address I �� /J' I License # I <br /> ELECTRICIAN Company I <br /> Signature Registered Y / N I Fee Current 1 Y/ N I <br /> Address I I License # I I <br /> PLUMBER Company <br /> Signature Registered Y / N J Fee Current I Y/ Ni <br /> Address I I License # I I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N 1 Fee Current I Y/ N <br /> Address I I License # I I <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address License # <br /> R0. i`;9;'�»r?a1:3` ,.A, ..:d+:�Yyna a ,..,, mz�'• xt 4w¢ �1F "P4€d ;' .':a..�R. `: ., r.tk!r'�- ., ,«:�.'fi«t`A.*h 3��""T?'.E' debt.' Fw# .'�4Ya>w�"3'�°+Jtulb&*eG:�c."r. ........ .daida.�ikd.�.'�,�..v.. .q. <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 - days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br /> • <br />