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• <br /> • . 813-780 -0020 City ofZephyrhills'Fire:• • . <br /> Fax-813-78o-0021 <br /> Permit Application <br /> Date Received - Phone Contact for Permit I J <br /> Owner's Name CRukeg oF 1 L (VINS :b 1 Owner's Phone Number I 11 l 1 <br /> Owner's Address 522 o TEtJT$ ST, • <br /> Fee Simple Titleholder Name Titleholder. Phone Number I 1 <br /> Fee Simple Titleholder Address l <br /> Job Address • • Lot# <br /> Sub Division - - Parcel # <br /> I Bio-Hazard Waste Storage - .ANNUAL n Fumigation Tent , <br /> n Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier it or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> • n Emergency Generator < 30 kw n LP /Natural Gas - installation - <br /> Emergency Generator> 30•kw I . I LP/Natural Gas - ANNUAL Sale <br /> El Fire Protection Maintenance - ANNUAL • • Places of Assembly- ANNUAL . <br /> - T1 'jsemi� ®• Othe <br /> Sprinkler r ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ o I 1 1 1 Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ l 1 1 1 Sprinkler 'System installations <br /> • Hood Suppression E ❑ ❑ ❑ .1 ( n Standpipes (Sprinkler Sys) • <br /> • <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> 0 <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application - ANNUAL ( Valuation of Project <br /> • <br /> Fuel Tanks <br /> FT Other: -1 -eag Contractor - - Company Signature . . ' Registered Y / N Fee Current • Y / N 1 <br /> Address 'I License # 1 <br /> ELECTRICIAN - Company . <br /> Signature • Registered Y / N j Fee Current Y/ N <br /> Address I I License # 1 <br /> PLUMBER Company <br /> Signature Registered Y/ N j Fee Current I Y/ N <br /> Address ) • ( Li <br /> License # <br /> MECHANICAL Company <br /> Signature Registered Y / N Fee Current I Y./ N <br /> Address 1 I • License # 1 <br /> OTHER Company - <br /> Signature Registered Y/ N j Fee Current I Y/ N - <br /> Address License # - Directions: . <br /> Fill out application completely. • <br /> Owner & Contractor sign back of application, notartzed (Or, copy of signed contract with owner) . <br /> If over $2500, a Notice of Commencement is required .(Mechanical work over $5000) <br /> r 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 /> • <br />