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813- 780 -0020 City of Zephyrhills Fire <br /> Fax - 813 - 780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> .gin . =.zr�.s:x xta <br /> Owner's Name I ANDERSON PRESSURE CLEANING I Owners Phone Number I ,., <br /> IR7 3 I IRR4 I IS9nR <br /> Owners Address I 5104 MURRAY HILL DR, TAMPA, Ff,. 33615 -4734 I <br /> Fee Simple Titleholder Name I I Titleholder Phone Number I II 11 I <br /> Fee Simple Titleholder Address I <br /> Job Address (GOLDEN CORRAL 6855 GALL BLVD. . ZEPAYRHILLS . FL. 33 542 -25 76 I Lot # <br /> Sub Division I I <br /> I Parcel # I I <br /> I - I Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I Controlled Bum I Hood Installation <br /> I - I Emergency Generator < 30 kw LP/Natural Gas - Installation <br /> n Emergency Generator > 30 kw = LP /Natural Gas - ANNUAL Sale <br /> I — I Fire Protection Maintenance - ANNUAL Places of Assembly- ANNUAL <br /> 4;j)'J IbemiI r7M11 'tither <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm f ] ❑ ❑ ❑ I I I I Sparklers <br /> Hood Cleaning ® ❑ ❑ ❑ I I I I Sprinkler System Installations <br /> Hood Suppression 0 ❑ ❑ ❑ I I I Standpipes p pas (Sprinkler Sys) <br /> Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> Fire Pumps a Waste Tire Storage ANNUAL <br /> 1 Fire Works <br /> Flammable Application- ANNUAL I <br /> Fuel Tanks <br /> Valuation of Project <br /> ni Other: I <br /> " w: R�.-g ma+.* �a z- ., �Z4 �c&s'€w ' tea,. ( <br /> Contractor I I r _ . �::. <br /> Signature <br /> Company <br /> Registered I Y/ N J Fee Current I Y/ N J <br /> Address I <br /> I License # 1 I <br /> ELECTRICIAN( <br /> Signature <br /> Company I <br /> Registered I Y / N . Fee Current I Y / N I <br /> Address I I I <br /> License # I <br /> PLUMBER I f <br /> Company I <br /> Signature <br /> Registered i Y/ N . Fee Current I Y/ N I <br /> Address I <br /> 1 License # <br /> MECHANICAL' I <br /> Signature I Company <br /> Registered ( Y/ N J Fee Current I Y/ N I <br /> Address I I I <br /> License # I <br /> OTHER <br /> Signature I Company I <br /> I Registered I Y/ N J Fee Current I Y/ N <br /> Address <br /> License # <br /> D irections: <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 party Tax Notice (httpJ /appreiser.pascogov.com) <br />