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813 - 780 -0020 City of Zephyrhills Fire Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received <br /> , ...6 --- c4 ,- 0 g I Phone Contact for Permit 1 I I I I I <br /> Owner's Name I✓ l.0eir%y All F I Owner's Phone Number I 1 1 I I I <br /> Owner's Address <br /> I <br /> Fee Simple Titleholder Name I I Titleholder Phone Number 1 1 1 <br /> Fee Simple Titleholder Address ( <br /> Job Address /37.9/5 /5 1 7 l ri 33•.52 Lot # I <br /> Sub Division <br /> I � / �/S ,Z I Parcel # I I <br /> El Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> Il Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL. .9/5 <br /> Lr <br /> 0 Controlled Burn n Hood Installation a <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation / ;/ / / -` . . <br /> 0 Emergency Generator > 30 kw n LP /Natural Gas - ANNUAL Sale �( <br /> 0 Fire Protection Maintenance - ANNUAL n Places of Assembly - ANNUAL 1 (� / v3 <br /> 4 <br /> Frifiryl ISemij MI Other t -I <br /> Sprinkler 0 xi ❑ ❑ IT Recreational Burn <br /> Fire Alarm D ❑ ix ❑ ( 1 IT Sparklers <br /> Hood Cleaning 0 ❑ ❑ ❑ II 1 n Sprinkler System Installations <br /> E I=1 I=1 CI Suppression I 1 IT Standpipes (Sprinkler Sys) <br /> 0 Fire Alarm Installation El Torch Roofing/Tar Kettle <br /> I Fire Pumps n Waste Tire Storage ANNUAL <br /> El Fire Works <br /> E Flammable Application - ANNUAL I I Valuation of Project <br /> El Fuel Tanks <br /> I Other: ( I <br /> Contractor Company ��% ,��/ r � <br /> Signature !� Registered Y / N Fee Current Y / N <br /> Address I License* <br /> ELECTRICIAN Company I <br /> Signature Registered Y / N 1 Fee Current I Y/ N I <br /> Address I I License* I <br /> PLUMBER Company I <br /> Signature Registered Y/ N 1 Fee Current I Y/ N <br /> Address ( I License # I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N 1 Fee Current I Y / N <br /> Address I I License # I <br /> OTHER Company I <br /> Signature Registered Y / N 1 Fee Current I Y/ N <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 />