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• <br /> 813 - 780 -0020 ` City of Zephyrhills •Fire 4 O y, J i # 5 Fax - 813 -780 -0021 <br /> • <br /> Permit Application - _ <br /> )ate Received Phone Contact for Permit elriEll <br /> )wners Name ` 1 5 \ to C.- 0A4 11 . i—L C I Owner's Phone Number <br /> 't-C) 3 LI O 15 5 i a leY∎ a. 3 3l, q 7a <br /> owners Address � <br /> Titleholder Phone Number <br /> =ee Simple Titleholder Name I I = I 1 <br /> Titleholder Address <br /> es Simple _. ,... , , � .rH ,.. u r .�T <br /> I c.Q�k5 PtU (AV S * uA = tDn -l ( K Li 114 t 1 Lot <br /> # <br /> ::: � l /_ <br /> Ci • Parcel # l 0 3 - d(o <br /> Sub Division • 1 <br /> U� �ov v <br /> ri Bio- Hazard Waste Storage - ANNUAL a Fumigation Tent <br /> 0 Comm Exhaust Kitchen Hood/Duct r --- 1 Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I - I Controlled Burn El Hood Installation <br /> I — I Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> map ISemiJ �utrier <br /> Sprinkler ❑ ID ID FT Recreational Burn <br /> Fire Alarm ❑ 0 7r 1 1 n Sparklers <br /> Hood Cleaning ❑ ❑ ❑ I 1 1 I Sprinkler System Installations <br /> Hood Suppression El ❑ ❑ ❑ I I in Standpipes (Sprinkler Sys) <br /> ED Fire Alarm Installation a Torch Roofing/Tar Kettle <br /> 1M Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL , I Valuation of Project <br /> Fuel Tanks <br /> n Other: ,;a� <br /> Contractor Company �►�� ' . IMOIt `' <br /> Signature Registered Mal Fee C rrent [OM" <br /> Address +1 eN Illr "MM ��NEN M.. 5 License # k 00 n 0 q <br /> ELECTRICIAN � Company <br /> Signature nature Registered Y / N Fee Current Y / N <br /> Address I I License # I 1 <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current 1 Y / N I <br /> Address I ( License # I 1 <br /> MECHANICAL Company I <br /> Signature Registered Y / N I Fee Current I Y/ N I <br /> Address I 1 License # } 1 <br /> OTHER Company <br /> Signature Registered Y/ N I Fee Current I Y / N j <br /> Address License # <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 />