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813-780-0020 City of Zephyrhills Fire "50 max -o " - ' °V -V V" <br /> Permit Application - j . <br /> Date Received - <br /> eceived J Phone Contact for Permit <br /> Owner's Name 7e0 �` 11l ��S VOC1 1 L L C I Owner's Phone Number . 1 1 1 <br /> Owner's Address -- 1713W "SIC, l 1 7 luct , 7 -- 1 4 1( 1=(_ ( T� , <br /> Fee Simple Titleholder Name Titleholder Phone Number , <br /> Fee Simple Titleholder Address I I <br /> Job Address J-{U t ( EVd 7 -P \( / i-- { Lot# <br /> Sub Division Parcel # <br /> E3 Bio -Hazard Waste Storage - ANNUAL = Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct a Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n i Controlled Bum n Hood Installation <br /> EJ Emergency Generator < 30 kw a LP /Natural Gas - Installation <br /> ED Emergency Generator> 30 kw a LP /Natural Gas - ANNUAL Sale <br /> a Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> r!iril7 emi ma Other <br /> Sprinkler g ❑' ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I 1 Q Sparklers <br /> Hood Cleaning 0 ❑ ❑ ❑ 1 a Sprinkler System Installations <br /> Hood Suppression I= ❑ ❑ ❑ I ( a Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> Fire Pumps Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL ( Valuation of Project <br /> Fuel Tanks <br /> Ln Othe il� g • _ <br /> Contractor ■ IMF I � <br /> Company �MIMMIT anal.111.1 <br /> Signature MI + <br /> - <br /> t, Registered mum Fee Current Y / N <br /> Address r/`.'!EWi•lIIIIr1' ll1111111M11"'�IIKOI 6/11 . License # n([ mtar. 'c L'r TSMII <br /> ELECTRICIAN Company <br /> Signature Registered Y / N I Fee Current I Y/ N 1 <br /> Address I t t I License # I I <br /> PLUMBER f , Company <br /> • <br /> Signature •, a v. Registered L Y/ N f Fee Current I Y / Ni I <br /> Address I I License # I I <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current I Y / N I <br /> Address I License # I <br /> OTHER Company <br /> Signature - Registered Y/ N I Fee Current I Y/ N 1 <br /> Address License # <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 />