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813-780 -0020 City of.Zephyrhills - Fax- 813-780 -0021 <br /> Permit Application _ . <br /> r, <br /> Date Receive Phone Contact for Permit <br /> Owner's Name AL gwp'f Owners Phone Number 8/_3 7f'4- 3s <br /> Owners Address .5397 G',. 44- 210c vD Ze -Zi /S AZ. <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I I <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> s3S' r?. k' t33- sw,rti.^?`a'r*vra'c* <br /> ri Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> FT Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> FT Controlled Bum I Hood Installation <br /> I — I Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> fi Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL I- Places of Assembly- ANNUAL <br /> (c.ttriy1'Seml [J other <br /> Sprinkler n ❑ ❑ ❑ I I Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ [ I I Sparklers <br /> Hood Cleaning ® ❑ A ❑ I I I 1 Sprinkler System Installations <br /> Hood Suppression Cg ❑ X ❑ I 1 n Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation I Torch Roofing/Tar Kettle <br /> H Fire Pump <br /> n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL I Valuation of Project <br /> Fuel Tanks <br /> (] Other: I I <br /> 4 °t<''°ITZ <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 # I <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I <br /> MECHANICAL Company I <br /> Signature Registered Y / N 1 Fee Current 1 Y / N J <br /> Address I License # I <br /> OTHER e - Company ' die— <br /> Signature Registered r&�J Fee Current "� <br /> Address License # j /// j .=r <br /> • $, Directions: <br /> aA�..tL».'4"r aines>'aw x. ..w,y,r .�fWna. s...,r d.. .......:.:,..,, ._.„ „a.,M.,.�, ,.::.t:,: >,>_,.,. - .,.Y'�n3.,_ °ds:."1 ..&*. __,._ .M ss,'h. -r zY"R.wi:eY4z1,`:�"_ ^ <br /> Dire <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 />