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813- 780 -0020 City of.ZephyrhillsFire Fax- 813 - 780 -0021 <br /> Permit Application <br /> Date Received ;1 y7 J / « Phone Contact for Permit <br /> l <br /> Owner's Name eak-k "&j t fl n 1 ! c Owner's Phone Number y ► 3 '7 /J 0 �)/ <br /> Owner's Address 51 L i 3 C Ctr Zep h y r ti 1 I k FL <br /> , <br /> - <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address Lot# <br /> Sub Division Parcel # <br /> .; ••, . _,.„ ?":: ,. r .«a.:w:4=- 4%m,w riAriW .' ,:w4:>' ,",.,,u3m.. "r ; ". ;iram,'" a't'maamm�".,"r rw;: ....�..; z . rgtr ga ',,sol i , ,, .:E , ,g , „ :,;.,- : ..Ez ; <br /> I Bio-Hazard Waste Storage - ANNUAL ( I Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier 11 or RQ Facility) ANNUAL <br /> Controlled Bum I I Hood Installation <br /> I Emergency Generator < 30 kw I I LP /Natural Gas - Installation <br /> 1 Emergency Generator > 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> I- Fire Protection Maintenance - ANNUAL I Places of Assembly- ANNUAL <br /> lUtrly1 1Semil I""' 1 Uther <br /> Sprinkler 7 ❑ 10 n Recreational Bum <br /> Fire Alarm ✓ ❑ ❑ 1 I Sparklers <br /> Hood Cleaning I ❑ ❑ ❑ I 1 I Sprinkler System Installations <br /> Hood Suppression C ❑ ❑ ❑ I I I Standpipes (Sprinkler Sys) <br /> I Fire Alarm Installation I Torch Roofing/Tar Kettle <br /> Fire Pumps I I Waste Tire Storage ANNUAL <br /> I Fire Works <br /> n Flammable Application- ANNUAL I Valuation of Project <br /> Fuel Tanks <br /> F1 Other: I <br /> >...,. :.2 ,..4_ ^`K•':".:.t, '"'AmiteMmm`,m,2 g .,,. -mi fay s ermat a• w,ig..: " ,;w:. '. ...° .. . , *a'. 3_=' ;,: «° ..,wt.: _ . ._...: .x.m 5i1 .•.:Z . =.....u'` .: a.. ,•.. :.sue N,.,. 22ZEi MUECt=2..,, <br /> Contractor — Company yi v y GS S I <br /> Signature Registered Y/ N ( Fee Current I Y/ N I <br /> Address 14 1 9 3 D 4.J W P.- fl z L 1v'4 3 i '3 4 License # I <br /> ELECTRICIAN Company <br /> Signature Registered Y / N j Fee Current I Y/ N I <br /> Address I <br /> 1 License* <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Current I Y/ N <br /> Address I I <br /> License # <br /> MECHANICAL Company <br /> Signature Registered Y / N Fee Current I Y / N <br /> Address <br /> I License # <br /> OTHER <br /> Company <br /> Signature Registered Y/ N J Fee Current I Y / N <br /> Address j License It I <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 />