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813- 780 -0020 City of Zephyrhills Fire Fax- 813- 780 -0021 <br /> Permit Application <br /> Date Received 1 81r g I ci 1 Phone Contact for Permit 1 9 3 1 1 241 1 1 41 � 1 <br /> Owner's Name I T Id `\ � 1 o'« Pio - tits I Owner's Phone Number 1 613 1 032- I I 4 <br /> 1 , 4 1 <br /> Owner's Address 1 s W bbd 3)c' "' v \-"^ C_Z SO401- q'I 9 t <br /> Fee Simple Titleholder Name I Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address f It/, MA \ F 1 / 4 - k � � t ,ELL s r L 3 3 5 - '1 2_ Lot # <br /> Sub Division I 1A I Parcel # '02- 2.(0- Z'' 0O10 - 039co <br /> E Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> E Comm Exhaust Kitchen Hood /Duct I-1 Hood Installation <br /> El Controlled Bum n LP /Natural Gas - Installation <br /> n Emergency Generator < 30 kw I LP /Natural Gas - ANNUAL Sale <br /> n Emergency Generator > 30 kw n <br /> Places of Assembly- ANNUAL „� <br /> Fire Protection Maintenance - ANNUAL n Recreational Burn / -' _}� <br /> 61/ <br /> ry 'SemilMa N�� SG4v El Sprinkler ❑ 6- n Sparklers <br /> Fire Alarm ❑ ❑ ❑ I 1 n Sprinkler System Installations ( Hood Cleaning ❑ I=1 ❑ 1:1 I I n Standpipes (Sprinkler Sys) ��� <br /> �/ <br /> Hood Suppression n ❑ ❑ ❑ I 1 n Torch Roofing/Tar Kettle <br /> El Fire Alarm Installation I Waste Tire Storage ANNUAL <br /> J Fire Pumps <br /> Fire Works <br /> E Flammable Application- ANNUAL <br /> 1 I Valuation of Project <br /> El Fuel Tanks <br /> 0 Other: I I <br /> Contractor X• �j� , ) Company ' 1 t c� Pr -te_c. , e. <br /> Signature / ` lib. �O <br /> Registered � Fee Current KIM <br /> Address I - igo\ CD C- SS \O(ak 'k( i - r a vv Cl. E L .3(0491 License* Cl Ip q 2 o2 00 o t ‘9251 <br /> ELECTRICIAN Company I <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address I I License # I <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # ( I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I <br /> OTHER Company I <br /> Signature Registered Y/ N 1 Fee Current I Y/ N <br /> Address I I License # I <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 />