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813-780-0020 City of.Zephyrhills"Fire tom' Fax - 813- 780 -0021 <br /> Permit Application l . <br /> Date Received 1 - "OA 0 - 08 10 . <br /> - Phone Contact for Permit <br /> .._.uG':'"�,i,"•,-'�ks+�:rcs *Y. rai, .:'#:r+x.e,.�.N., r ..,wz- dx..:n.,.,..aw.:.w. -.N.ar > ss,�. a�. - ..�.- .�,.. �._ . -:- , -,.,.- .:�: -mm+ v-....� �: -. `. £w:,.a .. IrarM .....ye.�...- . = =..-s....._.,,.. <br /> ����//�� yn /��J/ ,., <br /> Owner's Name L SL.LO % / FVTC..IIT7"/ 7 P� // / Owner's Phone Number . 213 1,� . 7 3,j/ <br /> Owner's Address P©, 3 0X `/ 73j ,� ■ L 336 7* <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> / >-• ss` r..?; sr , ..a«�t - / 'zs � - :-: <br /> Job Address / rf �/6S 0 �///c/ELS C1al-L. f7 /0 Lot# <br /> Sub Division Parcel # <br /> I I Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> El Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum Hood Installation <br /> I I Emergency Generator < 30 kw I I LP /Natural Gas - Installation <br /> I Emergency Generator> 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> I I Fire Protection Maintenance - ANNUAL I I Places of Assembly- ANNUAL <br /> lUtrlyl 'Semi) Uther <br /> Sprinkler I ❑ ❑ ❑ • Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I . I Sparklers <br /> Hood Cleaning I,. I al ❑ Q(1 I Sprinkler System Installations <br /> Hood Suppression I ❑ ❑ ❑ I I I Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation GC) LLD/ Mail - attly Torch Roofing/Tar Kettle <br /> Fire Pumps ME7fCS r0/(/ Lk : 741.4" I Waste Tire Storage ANNUAL <br /> I . I Fire Works <br /> Flammable Application- ANNUAL f ( Valuation of Project <br /> Fuel Tanks <br /> Other: I <br /> Contractor CompanyI/L% 1r� g� <br /> Signature Registered Y / N Fee Current Y / N <br /> Address 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 I Company I <br /> Signature Registered Y / N I Fee Current 1 Y / N <br /> Address I I License # I <br /> MECHANICAL Company I <br /> Signature Registered Y / N J Fee Current I Y / N <br /> Address I I 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 (http: / /appraiser.pascogov.com) <br />