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813 -780 -0020 City of.Zephyrhills Firs -- Fax -813 -780 -0021 <br /> Permit Application _ <br /> Date Received Phone Contact for Permit <br /> Owner's Name ,y' ' el) / 7-e/ Owner's Phone Number <br /> Owner's Address 3 g y- t-I- - Sr' ,4t---_ <br /> Fee SimpleTitleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> 1 <br /> Job Address 3 rY' q _ ST /4----C Marta) Lot # <br /> Sub Division Parcel # <br /> n Bio- Hazard Waste Storage - ANNUAL I ` I Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Burn n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> F - 7 Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> Icatny) !bermI WA Uther <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I 1 n Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I I I I Sprinkler System Installations <br /> Hood Suppression El ❑ ` ❑ 1 I n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> H Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> H Flammable Application- ANNUAL I ( Valuation of Project <br /> Fuel Tanks <br /> n Other: I <br /> ill � <br /> Contractor Company <br /> Signature l `� Registered Y / � F � <br /> e Current Y / N <br /> Address &M . -� * At d _ ` License # I <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I <br /> 1 License # I <br /> PLUMBER Company <br /> Signature Registered Y / N I Fee Current I Y/ N j <br /> Address I I License # I I <br /> MECHANICAL Company <br /> Signature Registered Y / N _I Fee Current I Y / N j <br /> Address I I License # <br /> OTHER Company <br /> Signature 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 />