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813-780 -0020 City of Zephyrhills Fire Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received 1 1 Phone Contact for Permit <br /> .. •'y? .. ,<. n. ..... .. :. s e ..::.. Aa, v, .3ny.:.?'�? '.. &:;E. E'S, m a�. , .a .a'aR -`:: ° 'w. ° .EbTfi"^_E -�S ;ei -^2 <br /> Owner's Name An C 4, i ii d s Owner's Phone Number [' 3 7 l; 78-ii 33 7 <br /> Owner's Address '/' G4,rL 8 )0 a- ,90; G4 , ' , <br /> / <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> Job Address / 5✓ 6 "j /4,F6 ,6 C ,,. j06 ze7ei' `T..t"GL S FL.. Lot # <br /> Sub Division Parcel # <br /> Z.Z «;'.. .. F .<. .4'R ;Z :...z =Ek z..344 »e...UMPL —444%9G sW: .W,RPI .# is d«' i '": O..1..BS"IMMAIR °G ^ 4.: ,11AVM ?a .e,M s m sir z ...'-2Za'Id` ss c.Azn:%&w"`".. -Re _ , ,tx.4.. ZOM; :'.4, &0 ,., ....1,1 ? 1741- "aN,, :a::w t;. <br /> pi Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier 11 or RQ Facility) ANNUAL <br /> I I Controlled Bum I Hood Installation <br /> I1 Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> 71 Emergency Generator > 30 kw I LP /Natural Gas - ANNUAL Sale /� , �1 / <br /> FT Fire Protection Maintenance - ANNUAL I Places of Assembly- A NNUAL 5 C C! 6O cite% <br /> Iutrl Isemil I�TI tither <br /> Sprinkler ❑ ❑ ❑ Recreational Bum 7"/ - 07 dr) <br /> Fire Alarm s <br /> n ❑ ❑ ❑ I I n Sparklers <br /> Hood Cleaning It ❑ X ❑ I I n Sprinkler System Installations <br /> Hood Suppression L1 ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> El Fire Alarm Installation I] Torch Roofing/Tar Kettle <br /> Ii Fire Pumps Waste Tire Storage ANNUAL <br /> ( I Fire Works <br /> Flammable Application- ANNUAL ' ` :S/ 5 -� ( Valuation of Project <br /> I i Fuel Tanks <br /> I—I Other: I <br /> ..R:z. _..a rkreka , 1a ,r t. Y a.a.::ria N+cwa.Ngitgi �° ..., Rim "WAtze e "reMe ..: eft a. tMig i .'a. K A ... w A R.. th, t._: k i zex w , .e.€;�;a:� s ° uVai ' .c..?' . t - °mmati la <br /> Contractor ^ /f <br /> {/ ..,/�" /C Company <br /> Signature ✓ Registered Y/ N I Fee Current I Y/ N J <br /> Address I 4 1/ 19/20(A-$4/26 1 to I License* <br /> vetffel'ITICTAITN �1 <br /> (8 C,? ` _ 7 o / ! 7 /fN I re.... s Company I <br /> ° / (0 Registered Y / N _I Fee Current I Y / N <br /> Address I I License # <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current I Y / N j <br /> Address I License # I <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I License # I <br /> Direc cion tions. <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 />