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813- 780 -0020 City of Zephyrhills Fire J Fax -813- 780 -0021 <br /> Permit Application <br /> Date Receivr-1 Phone Contact for Permit <br /> Owner's Name L(I WZr;ff 4Lfr Owner's Phone Number <br /> Owner's Address ‘ 3 7eP/S zse like <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address , 7 7J/5 /sex ',re Lot # <br /> Sub Division Parcel # <br /> I Bio- Hazard Waste Storage - ANNUAL I I Fumigation Tent <br /> El Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> I - 1 Emergency Generator < 30 kw I I LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> lUtrlyl IsemiI (,yv Uther <br /> Sprinkler N g ❑ ❑ I I Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ 1 1 I Sparklers <br /> Hood Cleaning n ❑ ❑ E l l I I Sprinkler System Installations <br /> Hood Suppression n ❑ ❑ ❑ I 1 n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps I I Waste Tire Storage ANNUAL <br /> I Fire Works <br /> I Flammable Application- ANNUAL <br /> Valuation of Project <br /> n Fuel Tanks <br /> n Other: I <br /> .. .t. x :,,,,,:2,,, ..�u...x €.. ....L.ux, ,..:a .max...ke.." ... ;. _.. >..,T . ,., ,...:aka ... .,_<€..;:N ....t4. ,E.. ..,. ,,...__...... .i.a.,1 <br /> Contractor Company �S�f , ' i _ <br /> Signature - Registered Y / N Fee Current Y / N <br /> Address <br /> License # <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address 1 I License # I <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current I Y / N <br /> Address I I License # <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current I Y / N J <br /> Address I I License # <br /> OTHER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I <br /> I Li I <br /> cense # <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 />