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813 -780 -0020 City of Zephyrhills Fire %90-7Q Fax -813 -780 -0021 <br /> Permit Application <br /> Date Received I 4 - 0 i I Phone Contact for Permit 1 813 11 909 11 0040 ete <br /> l ,. -. .- .. , .... -., .. <br /> I CITY OF ZEPHYRHILLS Owner's Name <br /> Owners Phone Numb 8 I 1 780 I ( 0022 <br /> Owners Address 1 5335 8TH ST., ZEPHYRHILLS, FL 33542 <br /> Fee Simple Titleholder Name I I Titleholder Phone Number I 1 1 11 I <br /> Fee Simple Titleholder Address I <br /> Job Address 39421 SOUTH AVE, ZEPHYRHILLS, FL 33542 I Lot# <br /> Sub Division <br /> Parcel # 1 12- 26 -21- 0000 - 04900 -0000 <br /> 0 Bio-Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> El Comm Exhaust Kitchen Hood /Duct n Hood Installation <br /> n Controlled Burn n LP /Natural Gas - Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale <br /> El Emergency Generator > 30 kw n Places of Assembly- ANNUAL <br /> Fire Protection Maintenance - ANNUAL In Recreational Bum <br /> El Leal semi' F rther I ❑ <br /> Sprinkler ❑ ❑ ❑ Sparklers <br /> Fire Alarm 0 ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Cleaning El ❑ ❑ ❑ I I El Standpipes (Sprinkler Sys) <br /> Hood Suppression El ❑ ❑ ❑ I I n Torch Roofing/Tar Kettle <br /> El Fire Alarm Installation n Waste Tire Storage ANNUAL <br /> El Fire Pumps <br /> El Fire Works <br /> 9 Flammable Application- ANNUAL ($20,700.00 I Valuation of Project <br /> Fuel Tanks REMOVAL <br /> Q Other: I I <br /> Contractor I John Klaser 17/2 a / ©q Company Tanktek dba Envirotek 1 <br /> Signature 0,0_4._v___ +` / Registered I I Y I I Fee Current I 1_(1 I <br /> Address 1 3007 N. 50th st. ampa, Fl 33619 I License # I PCCO55737 <br /> I <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N 1 Fee Current 1 Y/ N I <br /> Address I I License # I I <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I )if / N <br /> Address I I License # I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N 1 Fee Current I Y/ N I <br /> Address I I License # I <br /> OTHER Company I <br /> Signature Registered I Y/ N I Fee Current I Y / N I <br /> Address I I License # 1 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 />