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813 -780-0020 City of Zephyrhills Fire `/ ,1 Fax- 813 - 780 -0021 . <br /> Permit Application <br /> r. <br /> Date Receiveu i Phone Contact for Permit <br /> s I i f �,� <br /> Owner's Name l Qr / 0 T f 1�{'i ,�u�-eRE'Re Owner's Phone B' Number / 3 75.- 7.3.1 (.r7 <br /> Owner's Address (5/ / a Y s A . /VI /1s 3 3 [Z [ D <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I ( <br /> .N s .,, ,,.r z , V a ,:' . , A ; <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> n Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I I Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw I I LP /Natural Gas - Installation <br /> F - 7 Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sate <br /> n Fire Protection Maintenance - NNUA n Places of Assembly- ANNUAL <br /> y 'Semq 1771 Uther <br /> Sprinkler n ❑ ❑ ❑ I I Recreational Bum <br /> Fire Alarm ® ❑ ❑ ti I 1 I 1 Sparklers log <br /> Hood Cleaning 0 ❑ ❑ ❑ I 1 I I Sprinkler System Installations , , . �' 8 <br /> Hood Suppression Ei ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) 5 (( 2 91 <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle � eC l - J <br /> n Fire Pumps n Waste Tire Storage ANNUAL 724e- <br /> Fire Works <br /> I Flammable Application- ANNUAL <br /> 1 ( Valuation of Project <br /> n Fuel Tanks <br /> I Other: I e ...„,,,,,,..„. <br /> Contractor !i?I Company Registered Y/ N I Fee Current 1 Y/ N I <br /> Address 1 License # I <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y / N 1 <br /> Address I I License # <br /> MECHANICAL Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N <br /> Address I I License # I <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current I Y / N I <br /> Address I I License # I <br /> ..zi'2:.�, I, .., ..w..=~..:A....c.A„ ._„...... s. ,.,.,.., .�., �..._. .e:.... .. .... _., �.A�<,,..s.:...— .. ..,..�,:F,:.«..... ..: w..?v; - .� ,u.. ..F..,. _ __..,,A>s.... ,.. .A.......w �.. ...A .M...,xi_:... ..,.... <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 />