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813- 780 -0020 City of Zephyrhills Fire Fax- 813 -780 -0021 . <br /> Permit Application ,.. <br /> Date Received I _.. Phone Contact for Permit I I 1 I I <br /> Owners Name I ev fin /r/vA14/ a 4 ?"-e/ 07e , j Owners Phone Number 11 6C 1 1 272 1 (3 ''V 1 <br /> owners Address I C3 o /%'S zit -' 7 � -/. /s ,Z <br /> Fee Simple Titleholder Name I I Titleholder Phone Number I 1 1 1 <br /> Fee Simple Titleholder Address I <br /> Job Address I ^ <br /> Lot # I <br /> Sub Division I Parcel # I <br /> ED Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen HoodlDuct n Hazardous Material (Tier 11 or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> a Emergency Generator < 30 kw = LP/Nature <br /> P/Natu al Gas - Installation <br /> n Emergency Generator > 30 kw n LP/Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> fir[ fl ® L•.u� <br /> Sprinlder Lj ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I I n Spenders <br /> Hood Cleaning © ❑ jg ❑ I I n Sprinlder System Installations <br /> . Hood Suppression © ❑ J ( <br /> i[ ❑ I I I i Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> ` Fire Pumps n Waste lire Storage ANNUAL <br /> Fire Works <br /> Flammable Application ANNUAL I I Valuation of Project <br /> Fuel Tanks <br /> I I <br /> ....,;„.....L., __ •. <br /> 0 Other. <br /> Contractor N Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I I <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N j Fee Current I Y/ N j <br /> Address I I License # I I <br /> PLUMBER Company I <br /> Signature Registered Y/ N 1 Fee Current I Y/ N 1 <br /> Address I I License # ( I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N <br /> Address I I License # <br /> OTHER � Company L <br /> Signature e, j" e ,e-d -4 L4 '-- Registered Fee Current <br /> Address WEnallirWhing77141PRIFAWNAM License # ♦ L "re-coo 1 • <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 />