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813- 780 -0020 City of Zephyrhills Fir 1% 3 ' Fax-813-780-0021 i. <br /> Permit Application - _. - <br /> Date Received - Phone Cordact fo Permit <br /> O wner's Name 1 \ c, ( Owner's Phone Number ) 1 1 --- 1 fl t I <br /> Owner 1 s Address I O3 � l \ (� l \ -1D OVA \kkkc N I <br /> Fee Simple Titleholder Name 1 1 Titleholder Phone Number I I I I I <br /> Fee Simple Titleholder Address I <br /> Job Address 1 Lot # <br /> Sub Division I 1 Parcel # I <br /> El Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood/Duct n Hazardous Material (ice II or RD Facity) ANNUAL <br /> n Controlled Bum ❑ Hood installation <br /> ❑ Emergency Generator < 30 kw n LP/Natural Gas - Installation <br /> ❑ Emergency Generator > 30 kw ❑ LP/Natural Gas-ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Races of Assembly - ANNUAL <br /> ® ®.® Uhler <br /> Sprinkler II ❑ ❑ ❑ I n Recreational Bum <br /> Fire Alarm - ❑ ❑ ❑ ❑ 1 ( ❑ Spadders <br /> Hood Cleaning ) ❑ El ( ( n System Hood Suppression El ❑ ❑ ❑ ( ( n Standpipes (Sprinkler Sys) <br /> ❑ Rre Alarm Installation n Torch Roam/Tar Kettle <br /> -R Fire Pumps n Waste Tire Storage ANNUAL <br /> Rre Works <br /> Flammable Application- ANNUAL 1 Valuation of Project <br /> Fuel Tanks <br /> III •1 er: I <br /> sir, <br /> . ....." �: <br /> Contractor ow „I <br /> Signature ,. i • __ & A —�� y� Company Y / N I Fee current I Y / N I <br /> Address � ei _ n _ Za �z eYi # I <br /> ELECTRIC <br /> Signature Registered Y/ N 1 Fee Conant I Y/ N 1 <br /> Address I I License # I <br /> PLUMBER Company I <br /> Signature Registered L Y/ N I Fee Current I Y/ N I <br /> Address 1 I Lice it ( I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N ( Fee Cunent I Y/ N I <br /> Address 1 ( License it I <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current L Y/ N I <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 It- obtained from Property Tax Notice (httpi /appraiser.pascogov -rota) <br />