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813 -180 -0020 City of.Zephyrhills Fire. q32-0 Fax- 813- 780 -0021 <br /> Permit Application <br /> Date Received I ntg 060- ®9 Phone Contact for Permit J3 .9 <br /> ...« ....:...:.i -4..w &,." 3Sreux... K.,m,.:,.�.=..0 .... , k.� >n,�. � ,au «.— 4 ..�.. �• z, .,_;.4 , s _ .. ..:.pa- +- .- ,:..,.e..+....,.+_ .,_..., ..,, ,.w�«w�. «�.« (.�_�. <br /> Owner's Name I-A -S'21 9 t/OR14477f Owner's Phone Number 213 5'.4s 193 S/ 1 <br /> Owner's Address PO /kW g738 ' / /1 TL 33 , 674 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> ,,... ;"r � l. `' `<r : f: #fin ^rax': ;t a ..,i r='� "ts•- z' ».�. s. -" '- ,. . .i a' ..., -sm. .. ..te a^ w ... H sue .� <,. 25M .x, aa.. , <br /> ////��/^��� /j am { . 7.'s P4/1/0171- <br /> x..10 (J � • <br /> Job Address / 37 ?' iv Z3L_PD Lot# <br /> Sub Division Parcel # <br /> I Bio-Hazard Waste Storage — ANNUAL n Fumigation Tent <br /> I I Comm Exhaust Kitchen Hood /Duct I I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Controlled Bum I I Hood Installation <br /> I I Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> Emergency Generator> 30 kw I 1 LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL 1 I Places of Assembly- ANNUAL <br /> IUtrlyJ (Semi] f F l Other <br /> Sprinkler n ❑ ❑ ❑ I I Recreational Bum <br /> Fire Alarm I ❑ ❑ ❑ I I I Sparklers <br /> Hood Cleaning I f;/ pf ❑ ❑ I I I Sprinkler System installations <br /> Hood Suppression I I ❑ ❑ ❑ I I I Standpipes (Sprinkler Sys) <br /> I 1 Fire Alarm Installation I I Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL f I Valuation of Project <br /> I Fuel Tanks <br /> I Other: I <br /> Contractor Company 1//V /r p t V / <br /> Signature Registered Y / N j Fee Current I Y / N 1 <br /> Address <br /> I License # <br /> ELECTRICIAN Company <br /> Signature Registered Y / N _I Fee Current I Y / N <br /> Address I 1 License # <br /> PLUMBER Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address 1 I License # I <br /> MECHANICAL Company <br /> Signature Registered Y / N _ Fee Current I Y / N j <br /> Address I License # I I <br /> OTHER Company <br /> Signature Registered Y / N J Fee Current I Y / N I <br /> Address 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 />