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813- 780 -0020 City ofZephyrhillsFire• I f V n / Q / J Fax -813 -780 -0021 i .. <br /> Permit Application � �/ <br /> Date Rece;4ed = Phorre Conrtacffor Permit <br /> Owner's Name I •tea \�owV I Owner's Phone Number 3 j 1-1—tat 1 1 s osfsl <br /> Owners Address I WIZV CQL, f 2 7• s % _ I <br /> Fee Simple Titleholder Name ( I Titleholder Phone Number I I I I I <br /> Fee SimplelltleholderMdress I I <br /> Job Address Lot # I <br /> Sub Division I 1 Parcel # I <br /> CD 1310- Hazard Waste Storage - ANNUAL n Fumigation TeM <br /> D Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier I1 or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> ED Emergency Generator < 30 kw a LP/Natural Gas - Installation <br /> Emergency Generator > 30 kw n LP/Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> Sprinker 1n ❑ ❑ ❑ n Recreational Bum <br /> ' Are Alarm 0 ❑ ❑ ❑ I 1 a Sparklers <br /> Hood Cleaning X ❑ ❑ I 1 0 Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ l 1 n Standpipes (Sprinkler Sys) <br /> ED Fire Alarm Installation Torch Roofingfrar Kettle <br /> Fire Pumps Waste Tire Storage ANNUAL <br /> n Fire Works <br /> FR Flammable Application- ANNUAL I Valuation of Project <br /> Fuel Tanks <br /> 11111 ,....: ► er. <br /> Contractor nature , tO R "'ten" Registered Y/N J Fee Current I Y/N J <br /> Address ' 1 tt , _ - va t,_ — • . License # I _ I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N J Fee Current I Y/ N I <br /> Address I I License # 1 <br /> PLUMBER Company <br /> Signature _ Registered Y/N I Fee Current I Y/N I <br /> Address I I License* I I <br /> MECHANICAL Company <br /> Signature Registered Y/N J .Fee Current I Y/N j <br /> Address I I License # I <br /> OTHER Company <br /> Signature Registered Y/N 1 Fee Current . I Y/N J <br /> Address License # <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 />