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913-780-0020 City of Zephyrhills Fire. Fax- 813 -780 -0021 <br /> Permit Application <br /> Date Received ELI Phone Contact for Permit fp 1 i f 79" 6 / <br /> Owner's Name Owner's Phone Number I <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I I <br /> ��jC� � ..,,. i > x: <br /> Job Address / / l C3�+ `/ ' ( R A, e c4' Lot # <br /> Sub Division Parcel # <br /> n Bio- Hazard Waste Storage - ANNUAL I I 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 /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> I I Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> I 1 Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL qi <br /> l Utny i (semi) t" "'t Other <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I I ( ( Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I I I 1 Sprinkler System Installations <br /> Hood Suppression 2 ❑ ]4 ❑ 1 1 n Standpipes (Sprinkler Sys) <br /> El Fire Alarm Installation l n Torch Roofing/Tar Kettle <br /> F Fire Pumps n Waste Tire Storage ANNUAL <br /> I I Fire Works <br /> I I Flammable Application- ANNUAL 1 .. ..,/4.-i- , ....,/4.-i- "� <br /> ( ( Valuation of Project <br /> n Fuel Tanks <br /> n Other: I <br /> Contractor Company Mee, - p154 ' � 1- ' <br /> Fr- - <br /> Signature � Registered Y/ N I Fee Current 1 Y/ N <br /> Address I L/7 ( C -4.. Fr., r- 6 toe- - 7G{..ia_. ( I License # - 2ys/fr� C9C� G'©CP <br /> ELECTRICIAN Company <br /> Signature Registered Y / N 1 Fee Current 1 Y/ N J <br /> Address I License # I <br /> PLUMBER Company I <br /> Signature Registered Y/ N i Fee Current 1 Y/ N I <br /> Address I I License # I I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N J <br /> Address ( I License # I <br /> OTHER Company <br /> Signature Registered Y/ N 1 Fee Current I Y/ N, <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 />