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813- 780 -0020 City ofZephyrhills - Fire 4 cio 5 Fax- 813 - 780 -0021 ;` <br /> Permit Application <br /> Date Received one Contact for Permit <br /> - Ph -- <br /> Owners Name 1 ,N \6„..) ,'< %.3e) rwo,,\A,r• 1b 1 Owner's Phone Number Pin h a Z I r► 11 o I <br /> Owners Address I O3 ‘"/ ST 7-d VA2A/\ AC■ t l..- I <br /> Fee Simple titleholder Name 1 I Titleholder Phone Neer I 1 11 11 I <br /> Fee Simplel itieholder Address ' <br /> Job Address 1 I Lot # 1 <br /> Sub Division 1 1 Parcel # I I <br /> ❑ Bio -Hazard Waste Storage - ANNUAL ri Fumigation Tent <br /> ❑ Comm Exhaust Kitchen Hood/Duct n Hazardous Materiel (Tier It or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP/Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP/Natural Gas - ANNUAL Sate <br /> n Fire Protection Maintenance - ANNUAL ❑ Places of Assembly- ANNUAL <br /> ® ®. EULl <br /> Spar 1I 0 ❑ 0 n Recreational Bum <br /> Fired Alarm ❑l o o ci f ��7 EJ Spariders <br /> Hood Cleaning N ❑ ❑ ❑ vim s ❑ SprinIder System Installations <br /> Hood Solon O ❑ 0 1 I f — 1 Standpipes (Spy Sys) <br /> ❑ Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> Are Pumps ❑ Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL l I Valuation of Project <br /> Fuel Tanks <br /> •' er. <br /> Contractor Company 1 <br /> Signature 111=4finti . Registered I Y/ N I Fee current Y/ N I <br /> Address - . _ _ice ._ 'S►X 'License# I <br /> ELECTRICIAN Company 1 <br /> Signature Registered Y/ N 1 Fee Current I Y/ N I <br /> Address ( 1 License # <br /> PLUMBER w I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address J ( Lime # I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N j Fee Current I Y/ N f <br /> Address I License # <br /> OTHER Company ' <br /> Signature Registered Y/ N Fee Current I Y/ N J <br /> Address License # <br /> Directions: T_ <br /> FM 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) eels of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http //appraiser.pascogov.con) <br />