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813-780 -0020 City of.Zephyrhills "Fir•.e Fax -813 -780 -0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> Owner's Name E1i 2 4 ti e 7:4 tr tjCoA0 - GAt., Owner's Phone Number 1 2,1 /.to4 <br /> Owner's Address 5ZS-,s- /47 2 yi-4#//J } <br /> Fee Simple?itleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> fi x' - ',.iP�`3th`..,;"re�,&!': •,s _ .. ...t"tTerwrfi ;.v.,s.r'', ry r., .,.;, .. _ tsr..�.,w. », «..e ..:;r, .,. ,. ..�b F.,. , x� *z.e :...,F ,.,.ati_:. �ce9'a .,.st+'Y'.^°,.. s,a :'#v ..W.,.° r- 9-r <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> fi ".,� _ �. r� .�w�.. ,. t� ,.. ,. ".•x ... ,_F�.�,<� - ,t <br /> = Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL nI Places of Assembly- ANNUAL <br /> lutnyl 1semII Ma Littler <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I I n Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression CO ❑ g ❑ I 1 n Standpipes (Sprinkler Sys) <br /> LI Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> n Flammable Application- ANNUAL <br /> 1 ( Valuation of Project <br /> E Fuel Tanks <br /> n Other <br /> Contractor Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N <br /> Address I I License # <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N I Fee Current 1 Y/ N <br /> Address I I License # <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N J <br /> Address 1 I License # I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N I Fee Current Y/ N <br /> Address I I License # <br /> OTHER .-- Company e dfi7 X' 6,-.0 u a <br /> Signature =►� Registered r.•rJ Fee Current EWE" <br /> Address License # SO261 / "• • <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> tf 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 />