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813-780-0020 City of Zephyrhills Fire ''/ q � Fax -813- 780 -0021 <br /> Permit Application l <br /> Date Received Phone Contact for Permit I I I <br /> Owner's Nama In %T['T! , I / ' O Phone Number X ).' 7 q -a"771 <br /> Owner's Address A7 JP gq" '1 h'p (-k )ks J 335i' <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> Job Address _ O l l 5 q V i ,5 1 '/10/91191-1111k + 7 �� 5 2- Lot # <br /> Sub Division Parcel # <br /> . < ....... t o :.',. _ ,ot , r .,, .... ;. uca ex „ �:3. M�. ,.,4r? w.. . _.s .. :m.,? ' 3sF,,_ a ., w.a, <,.... ,. .., , ..,..- , ,. _.. ... ., :',,,,—„' '' . - <br /> I I Bio- Hazard Waste Storage - ANNUAL ri Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> El Controlled Bum I Hood Installation <br /> I - I Emergency Generator < 30 kw I LP /Natural Gas - Installation <br /> I - I Emergency Generator > 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> I Catty 1 !SemiI rATTI Other <br /> Sprinkler I] ❑ ❑ ❑ I I Recreational Bum <br /> Fire Alarm I ❑ ❑ ❑ 1 1 1 1 Sparklers <br /> Hood Cleaning { ] ❑ ❑ ❑ 1 1 I 1 Sprinkler System Installations <br /> Hood Suppression n ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> I I Fire Alarm Installation Torch Roofing/Tar Kettle <br /> [ ] Fire Pumps ' Waste Tire Storage ANNUAL <br /> 1 1 Fire Works <br /> 7 Flammable Application- ANNUAL I I Valuation of Project <br /> El Fuel Tanks <br /> El Other: 1 <br /> . p.&62_, �4EZ. �. _ 1 z .l w.. � _ .. ...� . : :: . ....: E ;:za . w .. -M _ a ._ . ..k <br /> Contractor r / i � , Company 1 Signature' re / Registered Y / N 1 Fee Current 1 Y / N <br /> Address I I License # I I <br /> ELECTRICIAN Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address I I License # l I <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y / N <br /> Address I I License # I <br /> MECHANICAL Company I <br /> Signature Registered Y / N Fee Current Y / N 1 <br /> Address I I License # <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I 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 (http: / /appraiser.pascogov.com) <br />