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° 813-780-0020 City of Zephyrhills -Fire. Fax -813 -780 -0021 <br /> Permit Application <br /> Date Received /■ - Phone Contact for Permit r / 3 �•.,� g . <br /> Owner's Name I VJa.. // r e e h Owner's Phone Number I g/ 3 I I/ S I 1 ?J - 7/ <br /> r <br /> ner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> Job Address 4 'la? G- a // Blvd - Lot # <br /> Sub Division I Parcel # <br /> a Bio-Hazard Waste Storage ANNUAL I Fumigation Tent <br /> El Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I — ) Controlled Bum I Hood Installation <br /> ED Emergency Generator < 30 kw I LP /Natural Gas - Installation <br /> I - I Emergency Generator> 30 kw I-I LP /Natural Gas - ANNUAL Sale <br /> I Fire Protection Maintenance - ANNUAL r ---, Places of Assembly - ANNUAL <br /> ltttriyl 1bemiI raj other � <br /> Sprinkler n ❑ El n Recreational Bum Q "f / / <br /> / <br /> Fire Alarm il ❑ ❑ 1- Sparklers <br /> I 1 I 1 p <br /> Hood Cleaning n ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression 0 ❑ ❑ ❑ I 1 n Standpipes (Sprinkler Sys) <br /> El Fire Alarm Installation I Torch Roofing/Tar Kettle <br /> Fire Pumps r Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL I ( Valuation of Project <br /> Fuel Tanks <br /> El Other: I <br /> Ationsmunagastemareas <br /> Contractor Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N 1 Fee Current I Y/ N <br /> Address I I License # I I <br /> PLUMBER Company <br /> Signature Registered Y/ N 1 Fee Current I, Y/ N 1 <br /> Address I I License # ( • I <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current I Y/ N <br /> Address I I License # I I <br /> OTHER Company A Je C M r ' �j e Y 1/ G e 3 <br /> Signature Registered Y/ N I Fee Current ( Y/ N I <br /> Address / W IY2LZers " - 'Tit in o a PL 3.3 ,_342 License # Z 8 D d / . . 3 <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> tf 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 (httpJlappraiser.pascogov.com) <br />