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813 -, 80 -0020 City of Zephyrhills Fire I 0 -I 3 Fax -813- 780 -0021 <br /> Permit Application [ <br /> Date Received I 1 Phone Contact for Permit 1121 1 ti 2 1 q q 3 <br /> Owner's Name G ! , I. ,, i , J / `r , ` L L Owner's Phone Number fr/ 3 1 7 O 0 ' . &d <br /> Owner's Address 5 F 5a C A /M,• /eal/ ' !!A/ Ire 916 4I,P_)(drt VII (;),230 3 <br /> Fee Simple Titleholder Name ( Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> l ., , .. __ _ ...s�ars� / 'Ifs I LA . ,:,::� , .. _....: _ <br /> Job Address 9 3 / rA / 1/,.... r ‘.4. - f 1 2 e A 1 J f (5, r l )31 / Lot # <br /> Sub Division <br /> Parcel # <br /> Li Bio -Hazard Waste Storage - ANNUAL a Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> El Comm Exhaust Kitchen Hood /Duct n Hood Installation <br /> n Controlled Burn = LP /Natural Gas - Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale <br /> In Emergency Generator> 30 kw n Places of Assembly-ANNUAL <br /> © Fire Protection Maintenance - ANNUAL n Recreational Burn <br /> IQtrly) emi lid Other <br /> Sprinkler El ❑ ❑ ❑ El Sparklers <br /> Fire Alarm ® ❑ ❑ I 1 n Sprinkler System Installations <br /> Hood Cleaning ❑ ❑ ❑ I I Ej Standpipes (Sprinkler Sys) <br /> Hood Suppression 0 ❑ ❑ ❑ I I = Torch Roofing/Tar Kettle <br /> ri Fire Alarm Installation = Waste Tire Storage ANNUAL <br /> n Fire Pumps <br /> n Fire Works <br /> Li Flammable Application- ANNUAL I ( Valuation of Project <br /> E Fuel Tanks <br /> ❑ Other I <br /> .. _. .a_..� '...n ...s-,..:,.. ;: ._. e_.�L v�:c::. __. :tu _?si.a -- - v:t.:mxi:3z' � _or.;ri a3" -- ... _+:.. , :ii ivnik « �1..k.s._.n._ -_. . ... . . . <br /> Contractor Company A T 4 S ItA :-►•on . t. I <br /> Signature Registered Y / N Fee Current I Y / N } <br /> Address 3531 1'+¢9 .54 -en Rest. I License# ( EVOOOO 2 14i 1 I <br /> ELECTRICIAN Company <br /> Signature Registered Y / N I Fee Current I Y / N I <br /> Address I License # <br /> PLUMBER I Company <br /> Signature I Registered Y/ N I Fee Current I Y / N I <br /> Address I I License # I <br /> MECHANICAL Company <br /> Signature Registered Y/ N 1 Fee Current I Y/ N I <br /> Address I License # <br /> OTHER Company <br /> Signature Registered Y/ N I Fee Current I Y / N I <br /> Address I I <br /> License # 1 I <br /> Directions: <br /> Fit out application completely. <br /> Owner 8, 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 />