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813 -780 -0020 City of Zephyrhills - Fire Fax -813 -780 -0021 Permit Application Date Received Phone Contact for Permit MEN if 7& 6 r az a • : ems, .. �.. - :4 4 ... < _ ._ � s «: -:. *4.4a ,..: Owner's Name Owner's Phone Number I I Owner's Address Fee Simple Titleholder Name Titleholder Phone Number Fee Simple Titleholder Address °'�=.sis c7.*._. ..a'..�s" ,_.•.,., a. '.r ., .. .`. .,. Job Address ? & /3 6€ (/ b/ • CA.//.5 Lot # Sub Division Parcel # ;�- ;,:�r. u�3�mv- .. «fi e -•:_ >: ...� -' a;�..... ..n,.. �.�,z r '* =-:�. u.: ±.z :>. �. '� 444 �. p>. �, .... ki d. "Y. = °, :. .na,. ,re. I I Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent r-i Comm Exhaust Kitchen Hood /Duct IJ Hazardous Material (Tier II or RQ Facility) ANNUAL I - I Controlled Bum IT Hood Installation r — I Emergency Generator < 30 kw I I LP /Natural Gas - Installation I Emergency Generator > 30 kw Ii LP /Natural Gas - ANNUAL Sale 9/17 I — ) Fire Protection Maintenance - ANNUAL cx n Places of Assembly- ANNUAL Iny) (Semi l Other - Sprinkler TI ❑ ❑ ❑ I I Recreational Bum Fire Alarm PI ❑ ❑ ❑ I I Ii Sparklers Hood Cleaning n ❑ ❑ ❑ I I [] Sprinkler System Installations Hood Suppression 2 ❑ 24 ❑ I I I I Standpipes (Sprinkler Sys) I Fire Alarm Installation (i Torch Roofing/Tar Kettle I—I Fire Pumps n Waste Tire Storage ANNUAL n Fire Works I] Flammable Application- ANNUAL F � - 1611111 Valuation of Project 7 Fuel Tanks n Other Mir � Sr Contractor Company / • )PC - pt. /�1 - PI eC� / � 1 � r " Signature �� Registered Y/ N � Fee Current I Y/ N Address I - 1 . 7 c 1 ®G-c i % r � ■ t - 1.3 L" ;- -T2 _ 4 '( I License # 7z/5 I ELECTRICIAN Company Signature Registered Y/ N _I Fee Current I Y/ N 1 Address I I License # I i PLUMBER Company Signature Registered Y/ N I Fee Current I Y/ N I Address I I License # I MECHANICAL Company Signature Registered Y/ N j Fee Current I Y / N I Address I I License # OTHER Company Signature Registered Y/ N I Fee Current I Y / N J Address License # Directions: Fill out application completely. Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) If over $2500, a Notice of Commencement is required (Mechanical work over $5000) Supply two (2) sets of drawings with applicable documentation Allow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com)