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813-780-0020 l City of.Zephyrhills / O g 9 Fax - 813 -780 -0021 <br /> Permit Application <br /> Phone Contact for Permit <br /> Date Received 1 , -�.r -a .r <br /> 1 L1 5710 <br /> Owner's Phone Number <br /> Owner' <br /> wner'19 s Name � C nn .1T1 _ Q Y ^ Ul r1 Inc.. 1 <br /> Owner's Address f 2C1 X 1tOrY1 iVe �P ON AAR; k F c I L 1 - T) n <br /> Titleholder Phone Number I <br /> Fee Simple Titleholder Name <br /> Fee Simple Titleholder Address ( x <br /> C \ 1 1� • s FJ X33& -!t L# ot <br /> Job Address 1 on(r� oz- ,r 'i /v� /` ot <br /> Parcel # I oz a U ont C/L�n� <br /> Sub Division <br /> r . .ran <br /> teas cap. <br /> n , . Bio-Hazard Waste Storage - ANNUAL Fumigation Tent <br /> I I Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> 7 Controlled Bum Hood Installation <br /> I I Emergency Generator < 30 kw LP /Natural Gas - Installation <br /> FT Emergency Generator> 30 kw LP /Natural Gas - ANNUAL Sale <br /> ® Fire Protection Maintenance - ANNUAL ( Places of Assembly - ANNUAL <br /> )Utriyi IbemiI (An f `Other <br /> Sprinkler ❑ ❑ S I Recreational Burn <br /> Fire Alarm /i /, ❑ ❑ • <br /> I . 1 I I Sparklers <br /> Hood Cleaning I-I ❑ ❑ ❑ I I I i Sprinkler System Installations <br /> Hood Suppression Ti ❑ ❑ ❑ I 1 I Standpipes (Sprinkler Sys) <br /> r Fire Alarm Installation FT Torch Roofing/Tar Kettle <br /> I — I Fire Pumps n Waste Tin: Storage ANNUAL <br /> I I Fire Works I <br /> I I Flammable Application- ANNUAL Valuation of Project <br /> I I Fuel Tanks <br /> 7 Othe I ,.< <br /> At <br /> Contractor WILLA-, _ ' CoPant C(Jr�A1/ /(111. Fi' /r o ' l Tin . iry . <br /> Signature DI A �1A4 AA - Registered / N Fee Current (Tina,. N <br /> Address I Fr I License # IiJ F £ 1 I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address License # <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I License # I <br /> MECHANICAL Company . <br /> Signature . Registered Y/ N I Fee Current I Y/ N I <br /> Address 1 License # I <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address License # <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 />