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813 - 780 -0020 City of Zephyrhills Fire ... Permit Application Fax -813- 780 -0021 Date Received rte` 7 � ` - h one Contact for Permit Owner's Name I ( en 91-e, )t G t o A-9,11 I Owner's Phone Number I S12) I ram 151 Owner's Address I { � C rt ` _ � �/ � 1c �\ 1 C ' ta � 9 � V -33� v Fee Simple Titleholder Name I "l Titleholder Phone Number 1 I1 1 1 I I Fee Simple Titleholder Address I F-• =s§. ,�; —. . „K , ... ,.r r-.M r A. u , :: t,- . --�.. - " ,, , ,, ,3..", , , ,,, :,,l, gi O 2—. � X , � ‘)\ NAM- ` ��s�a��> ,a;.�;.*:�” x :„mo Job Address - Z2 ?h iY ti L %941 1 1 I L ot # Sub Division I Parcel # I I I Bio- Hazard Waste Storage - ANNUAL I I Fumigation Tent Ii Comm Exhaust Kitchen Hood /Duct = Hazardous Material (Tier II or RQ Facility) ANNUAL I-I Controlled Bum I I Hood Installation I I Emergency Generator < 30 kw I ( Emergency Generator > 30 kw I I LP /Natural Gas - Installation LP /Natural Gas - ANNUAL Sale I — I Fire Protection Maintenance - ANNUAL r--7 Places of Assembly- ANNUAL IUtry (Semi I 'A71 Other �Y Sprinkler ❑ ❑ I I Recreational Bum r Fire Alarm I ❑ ❑ ❑ I I Fl Sparklers 7 Hood Cleaning I ❑ ❑ ❑ i :::::::: I 1 I I ons ood Suppression ❑ ❑ ❑ I I I ) �✓ ,,/ F Fire Alarm Installation I I Torch Roofing/Tar Kettle I Fire Pumps I I Waste Tire Storage ANNUAL I I Fire Works n Flammable Application- ANNUAL I ( Valuation of Project Fuel Tanks n Other: 1 Contractor Company 3 Cyn e � C( Signature Registered Y/ N J � Fee Current I Y/ N j Address I `l I I License # I ELECTRICIAN Company Signature I Registered I Y/ N j Fee Current I Y/ N Address I ( I License # PLUMBER I I Signature Company Registered Y N . 1 Fee Current I Y/ N J Address I I I J License # MECHANICAL' I Signature Company I Registered Y/ N ] Fee Current I Y / N J Address 1 J I I License # OTHER I I Company Signature Registered Y/ N I Fee Current I Y/ N I 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 htt //a ( p: ppraiser.pascogov.com)