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813- 780-0020 City of Zephyrhills Fire. <br /> Fax - 813 - 780 -0021 <br /> Permit Application . <br /> late Received Q Phone Contact for Permit 1 1 T 1 1 <br /> .... __ �._.. _.x �...�sc :fi2- •.tea+' ._�...., - —� -- """w'.•'"'°� x. , -, �:,.. �...�y:.r"... Y,�- ...,_.. _.,_�... _ ��o:.o..,....r.. ..._ .. ..�.,...v. .,.....-u._............ <br /> )wner's Name I Z h De U e .1 V n'1 P <br /> 1y� ill Lk. C , Owner's Phone Number 1 5(13 15 T? . f <br /> )wner's Address • �Cchh 1C�w � F 1 <br /> � <br /> =ee Simple Titleholder Name I \ Titleholder Phone Number 1 <br /> :ee Simple Titleholder Address 1 <br /> Job Address L A i (` . e . a r i r 35 / Lot # <br /> i <br /> Sub Division Parcel # ' . i - ol - 0000 . - - Gi_'/ /d <br /> -:•• —.am: . E..�. • . <br /> , :a �- .... ,_ � -�� • ... :a =a- ' ._..:.. -x�rez�,""=r -., ;w .:�� Z .-.. ���eai�.,.-;,..-,. a� ..:..•,:r.,.a ... �- w,r.�>ss.a_. �... <br /> I Bio-Hazard Waste Storage - ANNUAL a Fumigation Tent <br /> D Comm Exhaust Kitchen Hood/Duct 1 1 Hazardous Material (Tier 0 or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> R Emergency Generator < 30 kw n LP /Natural Gas - Installation 1 <br /> Emergency Generator 30 kw I 1 LP /Natural Gas - ANNUAL Sa 4 / <--,•- <br /> 7 Fire Protection Maintenance - ANNUAL n Places of Assembly -ANNUA <br /> pan 'Semi1 Un Other <br /> Sprinkler ❑ ❑ ❑ E1 Recreational Bum <br /> Fire Alarm ❑ ❑ ty 1 n Sparklers <br /> Hood Cleaning ❑ ❑ ❑ 1 1 1 1 Sprinkler System Installations <br /> Hood Suppression F1 ❑ ❑ ❑ I 1 1 1 Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation I-1 Torch RoofinglTar Kettle <br /> 1 1 Fire Pumps n Waste lire Storage ANNUAL <br /> • <br /> 1 1 Fire Works <br /> 1 1 Flammable Application- ANNUAL ( Valuation of Project <br /> Fuel Tanks <br /> n Other. I <br /> ;� :._� _r . �.. i� - r..,. ..:..=r: - ..;..��r �< .:: : ... ..•,� � -;_ . _,. _,:.•,... ..sf,. � _..:. ,±x: ;...r.> ,.n ....,:,...�.. _:� -- '_... sus °•: -- � >«.�F..:� �.':,,_ <br /> Contractor ( Company c �: , Q ' C- ill <br /> • <br /> Signature • ■ b� Registered RIM Fee Current Y / N <br /> Address 11311112 111111. 'e _ ILV271111111WMILM111111111111. License* I FF (00 10..1( 1 <br /> ELECTRICIAN s Company <br /> Signature Registered Y/ N 1 Fee Current 1 Y/ N 1 <br /> Address I —1 License* 1 <br /> PLUMBER Company <br /> Signature Registered Y / N Fee Current Y / N <br /> Address I 1 License # 1 1 <br /> MECHANICAL Company <br /> Signature Registered Y / N 1 Fee Current 1 Y / N j <br /> Address I 1 License # 1 1 <br /> OTHER Company <br /> Signature Registered Y/ N 1 Fee Current 1 Y / N 1 <br /> Address 1 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 52500, 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 it - obtained from Property Tax Notice (http:llappraiser.pascogov.com) <br />