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813- 780 -0020 City of Zephyrhills Fire: Fax- 813 -780 -0021 . <br /> Permit Application =.. <br /> Date Received w Phone Contact for Permit r <br /> Owners Name 1 los /caS I Owners Phone Number 1 02/3 1 1 770 I 1 Gilf• <br /> Owners Address 1_ .3 5..g 0 // a, , . 1 4, -A, /6- ,. . <br /> Fee Simple Titleholder Name I I Titleholder Phone Number I 1 1 I <br /> Fee Simple Titleholder Address ( <br /> Job Address 1 I Lot # I <br /> Sub Division I I Parcel # l <br /> Bio- Hazard Waste Storage-ANNUAL Fumigation Tent <br /> El Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> f l Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP/Nahaal Gas - Installation <br /> El Emergency Generator > 30 kw n LP/Natural Gas - ANNUAL Sate <br /> El Fire Protection Maintenance - ANNUAL n Places of Assembly-ANNUAL <br /> l".7 ('1® • l . " <br /> Sprinlder Ej ❑ ❑ ❑ n Recreational Burn <br /> Fire Alarm n ❑ ❑ ❑ ( ( n Sparklers <br /> Hood Cleaning ❑ Ax. ❑ I I n Sprinkler System Installations <br /> Hood Suppression © ❑ g ❑ I ( n Standpipes (Sprinkler Sys) <br /> El Fire Alarm Installation Torch Roofing/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL I I Valuation of Project <br /> Fuel Tanks <br /> Q Other. I <br /> Contractor Company I <br /> Signature Registered Y/ N _I Fee Current I Y/ N 1 <br /> Address I 1 . License # ( I <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N j <br /> Address ( I License # ( I <br /> PLUMBER Company I <br /> Signature Registered Y/ N 1 Fee Current I YIN I <br /> Address I ( License # ) I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N i Fee Current I Y/ N I <br /> Address I ( License # ( I <br /> OTHER Company C a... _ _ f � - fwd L L c I <br /> Signature edee.KI. - Registered Fee Current <br /> Address � r' :N / s ib License # ♦ e OGc ( r <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 (httpJ /appraiser.pascogov.com) <br />