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813780-0020 l City of.ZephyrhillsFire. 4 (b330 Fax - 813 -780 -0021 <br /> - _ Permit Application L <br /> Phone Contact for Permit 1 t,,Th 1 5756 leg-Li <br /> Date Received <br /> Owner' <br /> wners Name c m L Pr ktk ('-e._ I el L Owner's Phone Number - <br /> Owner's Address Ibq 1 Kledk,1A 11)Qre. --- tP 1� 1r.1 kt t is F I ` � � <br /> Fee Simple Titleholder Name <br /> 1 f I Titleholder Phone Number I ( _ <br /> Fee Simple Titleholder Address <br /> a • /�/ ; F .!♦_ • Lot* Job Address ✓ 1 �, I. .Il /L , <br /> Parcel # t Z/ "W O A/� <br /> Sub Division c <br /> I I Bio-Hazard Waste Storage ANNUAL Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> El Controlled Bum I I Hood Installation <br /> n Emergency Generator < 30 kw I I LP /Natural Gas - Installation <br /> 1 I Emergency Generator> 30 kw LP /Natural Gas - ANNUAL Sale <br /> ® Fire Protection Maintenance - ANNUAL ( Places of Assembly- ANNUAL <br /> , � IUtnyl ISemi GLll !Other <br /> Sprinkler ❑ ❑ 01 Recreational Bum <br /> Fire Alarm ® ❑ ❑ • I • 1 I I Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ 1 I I I Sprinkler System Installations <br /> Hood Suppression n ❑ ❑ ❑ I 1 1 I Standpipes (Sprinkler Sys) <br /> I I Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL ` ( Valuation of Project <br /> Fuel Tanks <br /> fl Othe - =. <br /> Ai <br /> antantaltar <br /> Contractor ll 1/ Company x.11 u , r '- r ° 4 . i ' .s <br /> Signature k J& £.4 AI - I�� Registered MAIM Fee Current Waal <br /> Address I License # I f' (� 00 rs <br /> ELECTRICIAN Company I <br /> Signature Registered Y / N I Fee Current 1 Y / N I <br /> Address ( License # I ` <br /> PLUMBER Company 1 <br /> Signature Registered Y / N I Fee Current I Y/ N I <br /> Address I I License # <br /> MECHANICAL Company 1 <br /> Signature . Registered Y / N I Fee Current I Y / N I <br /> Address I I License # <br /> OTHER Company <br /> Signature Registered Y / N I Fee Current 1 Y / N I <br /> Address 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 clays for review after submittal date. Parcel # - obtained from Property Tax Notice (httpJ /appraiser.pascogov.com) <br />