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813-780-0020 City of Zephyrhills Fire CG 3O 1 Fax - 813-780 -0021 Permit Application -- Date Received J 1 Phone Contact for Permit 1'72_7 (I t/7/ I I nO //V Q 1 Owner's Name 11 >17-E V•I 1S NI . � a1©U (k ` I , / J ( , Owner's Phone Number ) I V 3 1 1 / 3 III (S ! 1 Owner's Address I L 1330 my i �i �� eTfl u, LL '3c I Fee Simple Titleholder Name I I Titleholder Phone Number I 1 1 1 1 I Fee Simple Ttleholder Address I I Job Address 1 -1330 c -n-k ) 'r 2 4 ( K-H"\ LLS e L e39-/Z__ C__ I Lot # I I Sub Division I I Parcel # I _ I n Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL Q Comm Exhaust Kitchen HoodfDuct Hood Installation CD Controlled Bum LP/Natural Gas - Installation I - I Emergency Generator < 30 kw n LP/Natural Gas - ANNUAL Sale Q Emergency Generator > 30 kw [J Places of Assembly- ANNUAL / Z) D ZJZ Fire Protection Maintenance - ANNUAL 1 1.1 Q Recreational Bum r , lal Sprinkler Ii UA ❑ ❑ ❑ 0 Sparklers /0 , OQA , • / 1/1 • Fire Alarm Ii ❑ ❑ ❑ I l fJ Sprinkler System Installations Hood Cleaning [J ❑ ❑ ❑ I 1 D Standpipes (Sprinkler Sys) Ws Suppression 0 ❑ j< ❑ 1 1 J Torch Roofing/Tar Kettle J ] Fire Alarm Installation I Waste Tire Storage ANNUAL Fire Pumps Fire Works Flammable Application- ANNUAL Valuation of Project Fuel Tanks ED Other: I I Contractor • lip r t;. 00 L Signature Registered MM. Fee Current ran Address I UDo 3 Lrr Ccx 1�T SI . FE16�S 13J `� � b License s I I ELECTRICIAN Company I Signature I Registered I Y / N I Fee Current I Y / N Address I 1 License # I I PLUMBER Company I Signature Registered I Y/ N I Fee Current I Y / N I Address I I License • I I MECHANICAL Company I Signature Registered I Y/ N 1 Fee Current I Y/ N Address I I License # I I OTHER I Company I I Signature Registered Y/ N I Fee Current I Y/ N Address I I License # I I Directions: Fill out application completely. Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) If over $2500, a Notice of Commencement is required (Mechanical work over $5000) Supply two (2) sets of drawings with applicable documentation Allow 10-14 days for review after submtl date. Parcel # - obtained from Property Tax Notice (Mfpi /appraiser.pascogov.com)