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813- 780 -0020 City of ZephyrhillsFire. <br /> 1 1111° ' <br /> Permit Application _ _._. <br /> Date Received r - Phone Contact for Permit j <br /> owners name 1 I lk ♦ A \ S 1 Owner's Phone Number � h 5 I 1 \\S3 <br /> Owner's Address 1 .-1 .2-s 47 c \ ,14Q �� �1�Qki:As , VII- <br /> Fee Simple Titleholder Name I I Titleholder Phone Number I ! 1 1 I <br /> Fee Simple "litleholderAddress I <br /> A . - . - _ .. .._ . . . . ,. , , „.. <br /> Job Address 1 1 Lot# I _. <br /> Sub Division I I Parcel # 1 _ <br /> a Bio- Hazard Waste Storage — ANNUAL n Fumigation Tent <br /> I Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RD Fealty) ANNUAL <br /> n Controlled Blatt fl Flood Installation <br /> ED Emergency Generator < 30 kw I LP/Natural Caere- lrtsmUation <br /> n Emergency Geenerator> 30 kw ED LP/Natural Gas - ANNUAL Sale <br /> Q Are Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> omen <br /> kl <br /> spriner ® ci 0 ❑ Re aeatanal Bum <br /> Fwe Alarm ❑ ❑ ❑ I I ED Sparklers <br /> Hood Cleaning N ' ❑ 0 I ( n Sprirtider system Installations <br /> Hood Suppression ❑ ❑ ❑ ( ( n Standpipes (Spr der Sys) <br /> EI Fire Alarm Installation a Tads Roofing/Tar Kettle <br /> Are Pumps 0 Waste Tse Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL , I Valuation of Project <br /> Fuel Tanks <br /> Contractor x 4,,,, t /n Company Y / N Fee Current Y / N I <br /> Signature 40 _ ��►v..�„ I <br /> __. yr <br /> _ - r L . i Li # ( I <br /> ELECTRICIAN Cody I I <br /> Signature 1 1 Revered Y/ N I Fee Current I Y/ in <br /> Address I I License # ( I <br /> PLUMBER Company I <br /> signature Registered I Y/ N I Fee Current I Y/ N I <br /> Address I I Lkense # I I <br /> MECHANICAL Company I <br /> Signature Registered I Y/N I Fee Current I Y/N I <br /> Address I I Ise # I I <br /> OTHER Company I <br /> Signature Registered Y/N I Fee Current I Y/N I <br /> Address License # <br /> Directions: <br /> FNt 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.(Mechanicat work over $5000) <br /> Supply two (2) sets of drawings with applicable documentation <br /> ANow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (httpi /appraiser.pascogov.com) <br />