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813- 780 -0020 City of Zephyrhills Fire I Di 01 Fax- 813- 780 -0021 <br /> Permit Application <br /> Date Received I I Phone Contact for Permit 1 <br /> 1 b $i - ' I his 1/ //n 1 <br /> Owner's Name �^ n � 1 Own er's Phone Number I <br /> Owner's Address I I <br /> Fee Simple Titleholder Name I I Titleholder Phone Number I <br /> Fee Simple Titleholder Address <br /> ,lob Address 5/ 0 C- LL ALV D Yai is, R. 3 Lot# <br /> Sub Division 1 Parcel # <br /> n Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> F Comm Exhaust Kitchen Hood /Duct n Hood Installation <br /> JJ Controlled Burn n LP /Natural Gas - Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale <br /> 0 Emergency Generator > 30 kw n Places of Assembly- ANNUAL <br /> i:: <br /> F <br /> Fire Protection Maintenance - ANNUAL n Recreational Burn <br /> ❑ (Qtrlyl emi Mal Other <br /> Sprinkler ❑ ❑ ❑ n Sparklers <br /> Fire Alarm I=1 ❑ ❑ ❑ ( I n Sprinkler System Installations <br /> Ia.� I O ( I <br /> Hood Cleaning � { ❑ ❑ I 1 0 Standpipes (Sprinkler Sys) <br /> •o. uppression ❑ ❑ ❑ n Torch Roofing/Tar Kettle <br /> El Fire Alarm Installation n Waste Tire Storage ANNUAL <br /> EJ Fire Pumps <br /> n Fire Works <br /> n Flammable Application- ANNUAL ( ( Valuation of Project <br /> n Fuel Tanks <br /> Q Other: <br /> Contractor <br /> Signature _ - -_ � <br /> — Company II Opt) V R.VI <br /> Registered Qiv7 Fee Current M =V* <br /> Address License # <br /> FI_ECTRICIAN 3 syy Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address <br /> 1 License # I I <br /> ?._UMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N <br /> Address <br /> I License # I I <br /> MECHANICAL Company <br /> signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I <br /> ETHER Company I <br /> signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I 1 License # <br /> r` <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 /> c:; Allow 10 -14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br /> ,i. <br />