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813 780 - 0020 City of Zephyrhills Fire A 353 <br /> Fax 813 780 - 0021 <br /> Permit Application <br /> Date Received ����irdip P hone Contact for Permit 1 I I 1 1 I <br /> Owner's Name J14 - l.. Inc • 1 i 5 Owner's Phone Number I I I 1 1 I <br /> Owner's Address 11 ?X X, IQQO - IpS4 11/1UD12 LA_ e / 2a11s' :oo 0 I <br /> Fee Simple Titleholder Name I I Titleholder Phone Number I I I I I I <br /> Fee Simple Titleholder Address I r <br /> Job Address 1112_1 GPNtL bLv b ZePft-I/ IzHh LLS , FL_ 33S 4 <br /> ( I Lot # I <br /> Sub Division I <br /> Parcel# I 5 .0S• 21 • 00 1D • b01 op 6IOI <br /> n Bio- Hazard Waste Storage - ANNUAL El Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n I Comm Exhaust Kitchen Hood /Duct n Hood Installation <br /> I I Controlled Burn I I LP /Natural Gas - Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale <br /> n Emergency Generator > 30 kw n Places of Assembly- ANNUAL <br /> Fire Protection Maintenance - ANNUAL n Recreational Burn <br /> (Qtrlyl (Semi I � Other <br /> Sprinkler ❑ ❑ Sparklers <br /> Fire Alarm El ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Cleaning 0 ❑ ❑ ❑ 1 1 0 Standpipes (Sprinkler Sys) <br /> Hood Suppression n ❑ ❑ ❑ I I n Torch Roofing/Tar Kettle <br /> n Fire Alarm Installation n Waste Tire Storage ANNUAL <br /> 0 Fire Pumps <br /> n Fire Works <br /> n Flammable Application- ANNUAL I <br /> n Fuel Tanks I Valuation of Project <br /> n Other: I I <br /> Contractor I Company I <br /> Signature Registered Y / N I Fee Current I Y/ N I <br /> Address I I License # <br /> ELECTRICIAN <br /> Signature I Company I <br /> I Registered I Y/ N I Fee Current I Y/ N I <br /> Address ( I License # I <br /> PLUMBER I I Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I <br /> MECHANICAL' I I <br /> Company <br /> Signature Registered Y/ N I Fee Current I Y / N I <br /> Address I <br /> ' / I License # I <br /> OTHER <br /> I ■/ J Company <br /> Signature a . l ATtL vt1= <br /> Registered MEN Fee Current rcam <br /> Address , ,L to _. • • ai _ J G v_ <br /> 3 • I" License # I Oq bzkn(oOoU lappet <br /> Directions: <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 />