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813 -780 -0020 City of Zephyrhills Fire Fax- 813 -780 -0021 <br /> • Permit Application <br /> Date Received Phone Contact for Permit J I <br /> Own <br /> er's Name r y 1/t rie S !',q t'�SCJ Owner's Phone Number (f8 SS <br /> Owner's Address &/t ( /( / (UI1 2e,/,. <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address f'^ Cd }4;,c,.> // &1)d (�H� <br /> t .il5 �� <br /> Sub Division Parcel # <br /> Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I Controlled Bum I I Hood Installation <br /> I - 1 Emergency Generator < 30 kw I I LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL 7 Places of Assembly- ANNUAL <br /> FITTyl I Semi l Other <br /> Sprinkler n ❑ ❑ ❑ I I Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I 1 n Sparklers <br /> Hood Cleaning n 1 I I I Sprinkler System Installations <br /> Hood Suppression D ❑ ❑ ❑ I n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> I I Flammable Application- ANNUAL <br /> 1 ( Valuation of Project <br /> Fuel Tanks <br /> F Other: <br /> Contractor Company <br /> Signature Mfr' 41112-, Registered Y/ N I Fee Current I Y/ N I <br /> Address I 1 License # I <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N J Fee Current I Y/ N j <br /> Address I I License # <br /> PLUMBER Company <br /> Signature Registered Y / N I Fee Current 1 Y/ N J <br /> Address I 1 License # <br /> MECHANICAL Company I <br /> Signature Registered Y/ N j Fee Current I Y / N 1 <br /> Address I I License # I <br /> OTHER Company I <br /> Signature Registered Y/ N 1 Fee Current I 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 # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br />