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• <br /> 813-780 -0020 City of Zephyrhills - Fire 44 9e 5k Fax -813- 780 -0021 . <br /> Permit Application _. <br /> P <br /> Phone Contact for Permit Date Received <br /> `` `,, <br /> Owner's Name }7� ('hill ` 3 e.l S JJ�[.ci e Qre Owner's Phone Number /,' R' ( T7 <br /> Owner's Address C))� r U Si { {{ <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address VM'C Lot # <br /> Sub Division Parcel # <br /> 41' -.-. `•^ e= ;x M� e""4411 4 '• .ate,' ' ,,e -,, 7 : ',,,,' :at. - .: .�:�.as'; ' . - _k" . ;..��. �.. °.. r: «,e, x14,4, s aN aid, ,;12. °' eTill. W , <br /> 1 Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> F - 1 Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL I I Places of Assembly- ANNUAL <br /> �Utrryl !semi( �CnT] Uther <br /> Sprinkler n ❑ ❑ ❑ I I Recreational Bum <br /> Fire Alarm ® ❑ ❑ v f l Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I 1 1 Sprinkler System Installations <br /> Hood Suppression n ❑ ❑ ❑ I J I I Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> Flammable Application- ANNUAL t I Valuation of Project <br /> n Fuel Tanks <br /> n Other <br /> iitrarzzammitorgai d '' ''''''''''' ''' .".' ''''' " ' '' `. ' ' ' ' '''' ' ' ' ' • ...'' .". ' ..' ,4 t.' ''''' . ' '''' 'AM. . ,, '',.. ". <br /> Contractor Company ( '� J Qf 4.4 tJQJ.rt�Y); G 5 fl <br /> II I <br /> Signature ) ""` L � Registered / N 1 Fee Current Y /1\I <br /> Address 1 e ; ,. .' t. -6 License # ( CR - OM lQ'-j(p <br /> ELECTRICIAN Company I <br /> Signature Registered Y / N I Fee Current I Y / N I <br /> Address I I License # I I <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N 1 <br /> Address I I License # I I <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current I Y / N J <br /> Address I I License # I <br /> OTHER Company 1 <br /> Signature Registered Y/ N I Fee Current 1 Y/ N j <br /> Address l 1 License # I I <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 />