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.. _ 513 -780 -0020 City of Zephyrhills Fire % 1 1,' Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received I 1 � Phone Contact for Permit I I I I I <br /> /1 <br /> Owner's Name 1 Westbrook ` , ai,or I Owner's Phone Number ( I 1 <br /> Owner's Address <br /> Fee Simple Titleholder Name I Titleholder Phone Number I I <br /> Fee Simple Titleholder Address <br /> Job Address 1 V101 Dairy I Lot # <br /> Sub Division I l I Parcel# I <br /> El Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Comm Exhaust Kitchen Hood /Duct El Hood Installation <br /> Controlled Bum = LP /Natural Gas - Installation <br /> El Emergency Generator < 30 kw = LP /Natural Gas - ANNUAL Sale <br /> Emergency Generator> 30 kw In Places of Assembly-ANNUAL <br /> J Fire Protection Maintenance - ANNUAL = Recreational Burn <br /> ry MEN iii Uther <br /> 5�edwlec� Sprinkler ® x CI I Eil Sparklers <br /> Pe r Fire Alarm D ❑ ❑ E l l I 0 Sprinkler System Installations <br /> 6'1 Hood Cleaning n ❑ ❑ ❑ I In Standpipes (Sprinkler Sys) <br /> Hood Suppression In ❑ ❑ ❑ I In Torch Roofing/Tar Kettle <br /> E Fire Alarm Installation n Waste Tire Storage ANNUAL <br /> Fire Pumps <br /> n Fire Works <br /> El Flammable Application- ANNUAL 1 I Valuation of Project <br /> Fuel Tanks <br /> 0 Other: I <br /> Contractor Company • i p- a a 10 I <br /> Signature Registered UA Fee Current WON <br /> Address 17 tb. � Ok.S31 ztlik PL gg. Tam G I License # I o g c,q t2.000 `VMS I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I 1 License # I I <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y / N I <br /> Address I I License # I I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N I Fee Current 1 Y / N I <br /> Address I I License # I <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # 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 />