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813-780 -0020 City of Zephyrhills Fire Fax - 813-780 -0021 <br /> Permit Application <br /> Date Received l Phone Contact for Permit 6;? J 33 i S I <br /> Ownes Name 5 �a�zz. <br /> r , X 4 V, n b, fe p // £ Owners Phone Number <br /> V,. <br /> Owner's Address 4/ t.( He (-? <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee SimpleTitlehoiderAddress I <br /> Job Address Lot# <br /> Sub Division Parcel # <br /> Bio- Hazard Waste Storage - ANNUAL [] Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum I I Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator > 30 kw n ).P /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL fir ' Places of Assembly- ANNUAL <br /> ILltrlyl ISemi l (J Uther Y <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I I n Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ I I I Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL I I Valuation of Project <br /> n Fuel Tanks <br /> E1 Other: <br /> ......'.'�„c...,_?.xia..x4r .,,..,. �YS. �... t� .�?�,�,.::i3ia��,�o-�ay:.;.�', "^'a'•.•s. z�,'..:. " 4. �.,; H. a�;..: ��...., �. sa:...<, Em�.., a2�� ...t�.....�,,..,+,S���G,...i �..,_ �.,,.�`� ,u..�. a2.�sik a «_..z,.`aamr..�'�...a.__<,_„ <br /> Contractor Company <br /> Signature /j3!. C Registered Y/ N I Fee Current I Y/ N <br /> Address I License # <br /> ELECTRICIAN Company <br /> Signature Registered Y / N I Fee Current ( Y / N <br /> Address I 1 License # <br /> PLUMBER Company <br /> Signature Registered Y/ N J Fee Current I Y/ N <br /> Address I ( License # I <br /> MECHANICAL Company <br /> Signature Registered Y/ N J Fee Current Y / N <br /> Address I I License # I l <br /> OTHER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N <br /> Address I 1 License # 1 <br /> _...,., <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 />