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813 - 780-0020 City of Zephyrhills Fire Fax - 813-780 -0021 <br /> Permit Application <br /> Date Received l I Phone ntact for Permit • Owners Name - - - Owner's Phone Number 1 ') T 117 al 2- ( 9 G <br /> Owners Address ` I I <br /> Fee Simple Titleholder Name I I Titleholder Phone Number I 1 1 1 1 <br /> Fee Simple Titleholder Address I I <br /> _ .,... ;� „ �e; a;�.s+v., ..., " -" .. ,„ `w:r� °�,� ' >��.:s�r:�'�rr rr�,�:;as= t�,'. ,� =e > . �,r� .:c.._a,.- ,. -..:�,. .� �,'.v =:� u.�,.. . ^.',:°r ., .�s...::., - a w - ' -.... �. i�,: �.- :, �:; ,: ,. <br /> :b Address .5--- 1 7 G 4-1 / t111744. Lot # <br /> Sub Division I Parcel # I <br /> ;ter A te ; >• .., ;..�..,' �� �. �:,��._ .'.c. < ;� �_- . >, u <br /> n Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier 11 or RO Facility) ANNUAL <br /> • <br /> n Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP/Natura � <br /> I Gas - Installation ,- <br /> r - i Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Salee <br /> IZ Fire Protection Maintenance - ANNUAL n Places of Assembly - ANNUAL <br /> f l !Semi ® =AZ. j � 9, , <br /> Sprinkler ❑ ❑ y Q,' n Recreational Bum f <br /> Fire Alarm 0 ❑ ❑ ❑ 1 1 n / Sparklers / <br /> Hood Cleaning El ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression El ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application ANNUAL I I Valuation of Project <br /> El Fuel Tanks <br /> • Other: <br /> "aY '&;xtiNY.".v5. +?`s�lk3!<]:,;k!£?Nty x+*"af '.e - . e:a.m. zh' -r "- iv Y.h,;Y CLS . 1,. 'arc - as. .. �+a:4! f..::i.. e:;'. 'tc.?.. w ry '''.:T ..`-' ,. >:s*y3tYP:i en . :• -'4tk *il P'\.a1?'.fl, . ,43 +5;.;vc, s?:.v:, 4' ..:a:.; ,ssiL :::. <br /> Contractor (J V , I'. „/ V / , Company -� F Fe f' teal ✓vs-2 <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Add - Ii ♦ _ _ , qb " - • - License # I ' S 4 I) &-7 a 0 o 0l ,tic. <br /> • <br /> ELECTRIC • N Company <br /> Signature Registered Y / N i Fee Current I Y/ N <br /> Address 1 I License # I <br /> PLUMBER Company <br /> Signature Registered Y/ N J Fee Current I Y/ N J <br /> Address I I License # I I <br /> MECHANICAL Company <br /> Signature Registered Y/ N J Fee Current I Y/ N I <br /> Address I - ( License # I wt. I <br /> • <br /> OTHER N l • Company �: zgr !• �[= .„4.1 1M _ <br /> Signatu - 1 Registered Y / N Fee Current Y / N <br /> Ad ress Mgr /_illW mam /j , License # • <br /> Direction- _ <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 />