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813"60 -0020" City of. Zephyrhills s Fax -813 -780 -0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> ,, Dwner's Name S ! Owner's Phone Number <br /> Pt Owner's Address -- _ap <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> pe Job Address Lot # <br /> Sub Division Parcel # <br /> ..w:i;`., ra�� ,:. �'w< ._a..;:. , �#€ z.4. va' �, ..,...,: �;a,±£.tie:&r..�.>::'iw"�"'r� ". ". •-�- _ �"«"" -.,�"" ..'.r....,., a:^�,x.�.,u.a,m»;,��3w_,� ._..... �::�� .,,. �v..,ak sue. .- „�.. ,-, .,w.,r� 4,.,.;�,�s,a��.rv,.,. <br /> Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Controlled Bum I I Hood Installation <br /> I Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator > 30 kw LP /Natural Gas - ANNUAL Sale <br /> I I Fire Protection Maintenance - ANNUAL tal Places of Assembly- ANNUAL <br /> 1Lttrly1 1Semr1 � Other -w <br /> Sprinkler n ❑ ❑ ❑ rze a roc nr aTl um <br /> Fire Alarm n ❑ ❑ ❑ I I I I Sparklers <br /> Hood Cleaning ❑ ❑ E l l I Sprinkler System Installations <br /> Hood Suppression I ❑ ❑ ❑ I I I Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> I I Fire Pumps I I Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL ( Valuation of Project <br /> I I Fuel Tanks <br /> n Other: I <br /> L <br /> ..,...x_.�a.... .,.. s�:x.. . �s$ F.�•'��..cF..�.s? +:.. <.�- .f�.. "�;..:_M'*.�sa :. - tip ,;� , .. �t ��r �:, 3� r.Z °,..,C.� �,;,..?a F.»'E � _LtMM- .w1..�.. <br /> Contractor Company <br /> Signature _ _ - - / Lam* 4 .11/1111 Registered Y / N I Fee Current I Y / N j <br /> Address 1 I License # I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Current I Y N j <br /> Address I I License # <br /> PLUMBER Company <br /> Signature Registered ` Y/ N I Fee Current I Y/ N1 I <br /> Address I I License # <br /> MECHANICAL Company <br /> Signature Registered Y / N Fee Current Y / N <br /> - <br /> Address I License # <br /> OTHER Company <br /> Signature Registered Y/ N J Fee Current I Y/ N I <br /> Address <br /> 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 />