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813 -780 -0020 City of Zephyrhills "Fire. q 5 ( 5 Fax -813 - 780 -0021 <br /> - Permit Application <br /> Date Received 7 19"" Phone Contact for Permit E`M EMI ai 2 <br /> Owner's Name I 1 Owners Phone Number I r I3 1770/ I 43s <br /> nets Address f <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> Job Address rya / G///V" : T r a c M i ■Su�� / Lot # <br /> Sub Division Parcel # - - c2/ — D /4D ,0 0'0D GD /D <br /> n Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier 11 or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> FT Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> ILItriyI lsemil ® Other <br /> Sprinkler E ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm iL ❑ ❑ I 1 n Sparklers <br /> Hood Cleaning El ❑ ❑ ❑ 1 I n Sprinkler System Installations <br /> Hood Suppression Ei ❑ ❑ ❑ 1 I 1 1 Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> 1 1 Flammable Application- ANNUAL I I Valuation of Project <br /> n Fuel Tanks <br /> n Other: 1 <br /> Contractor Company <br /> Signature Registered Y/ N j Fee Current 1 Y/ N J <br /> Address I I License # I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N J Fee Current 1 Y/ N j <br /> Address I I License # I I <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N <br /> Address I ( License # I <br /> MECHANICAL Company <br /> Signature Registered Y/ N j Fee Current I Y/ N <br /> Address I I License # 1 <br /> OTHER Company A ► J' S e Cat/ -. - - c E? <br /> Signature Registered tmm Fee Current IMAM <br /> Address -J / 4/ 1 7'e A 8- i id / / F :33 - I License # ,6 c2019 ,,:g <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 (httpl /appraiser.pascogov.com) <br /> • <br />