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813- ?80 -0020 City of.Zephyrhills' - Fire; Fax -813 -780 -0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> wua.. .exsshaVedawY.'agMkhw: x ;-R - w ro. -.�.„ [. 2 - •'v.'u .u. &. SN�"x?'. <br /> / - ,- - iuh 3' .,s A 5`a'iy -x - vtn?ar.- sres.�.9i, . waarw +wnvvwaYwM <wr+wwPW.lrWavu,a <br /> Owners Name '. c j s /�.t. Zivr✓�' ,4.20,441 Owner's Phone Number Ira ter y,�� <br /> Owner's Address v�.?2O /0n - 1.71 <?Q4,/,.4 ,r..G <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple - Titleholder Address I I Job Address Lot # <br /> Sub Division Parcel # <br /> .s:,&'s:.'A�. vta,.'?a?b.a ,'= F =%k+4 :,d? }; . - �.r. ="t .. �..stR; .m ;,ry r w =., . ,n .., ,. _k r,. :'.4x9 > .,4 D.�:r..a4tP,xn..Y w * .tH:F4, a s,.; J. M.t $,^.YSS a .Z+- a2b.,•..r. ,. ::°- AE.f.. - .;,t::"&res <br /> I 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 /> El Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> I I Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> I I Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> IC/My' ISemil GTa tither <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ 1 n Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression 15a ❑ A ❑ I I I 1 Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> F n Fire Pumps n Waste Tire Storage ANNUAL <br /> �jl Fire Works <br /> n Flammable Application- ANNUAL <br /> 1 ( Valuation of Project <br /> n Fuel Tanks <br /> n Other: I I <br /> Contractor Company <br /> Signature Registered Y/ N I Fee Current I Y / N - I <br /> Address I I License # I <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N I Fee Current I 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 I I License # I I <br /> MECHANICAL Company I <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address ( I License # I I <br /> OTHER \ Com an _ <br /> Signature ��k� 4-y\ Registered r Fee Cu nt � Vffl <br /> Address License # W : __ atl /� <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 />