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• <br /> 813-780-0020 U l City of Zephyrhills-Fire. � - 2 (J y Fax - 81 -780 -0021 <br /> - <br /> • <br /> Permit Application <br /> /ate Received .. <br /> I - Phone Contact for Permit - - _.,..a -, ...r, ., <br /> ) Contact <br /> !� <br /> Owners Phone Number 'Mil 7 <br /> Tnrner s Name <br /> Co 1 3 G- & a1 0 2p ► .. 5 . ... <br /> Owners Address � 1 I I <br /> Titleholder Phone Number J <br /> =ee Simple Titleholder Name <br /> ee Simple Titleholder Address <br /> L 2� h ��S F� 33sy a- I Lot# } <br /> � o , 3 C7- �. 1 �� r � 'fi _ b <br /> Job Address - <br /> � r h ; Parcel # 1 AO <br /> Sub Division ��. „�..: - <br /> n Bio -Hazard Waste Storage - ANNUAL El Fumigation Tent <br /> El Comm Exhaust Kitchen HoodlDuct <br /> Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> EJ Controlled Bum Hood Installation <br /> El Emergency Generator < 30 kw <br /> El LP /Natural Gas - Installation <br /> Emergency Generator> 30 kw LP /Natural Gas - ANNUAL Sate <br /> El Places of Assembly- ANNUAL <br /> Fire Protection Maintenance - ANNUAL ��{ <br /> ISemil Iutner I 1 <br /> Sprinkler li ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm ❑ IZ‹ ❑ I I 0 Sparklers <br /> Hood Cleaning El ❑ 0 ❑ I Sprinkler System Installations <br /> Hood Suppression <br /> ❑ ❑ ❑ ❑ I I El Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> IN Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL Valuation of Project <br /> Fuel Tanks <br /> n Other: I y� <br /> e , pc, Ort 4— ✓)C <br /> Contractor Company G # - � ` <br /> Signature 1 Registered (ISMS Fee Current 49 l N <br /> Address '� � �� <br /> Si�alriM1� ININI . ` = ZUNI License# 1 E ( 000 (0 y L0 I <br /> ELECTRICIAN 1 Company I <br /> Signature ,.. Registered ---7 171 Fee Current I Y / N <br /> Address ` I License # ` I <br /> PLUMBER I Company <br /> Signature II Registered Y / N Fee Current Y / N <br /> Address 1 I License # I I <br /> MECHANICAL 1 Company I <br /> Signature Registered L Y/ N 1 Fee Current 1 Y/ N 1 <br /> Address ` I License # <br /> I l <br /> OTHER I Company 1 <br /> Signature 1 Registered Y/ N I Fee Current I 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 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br />