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813-780-0020 City of.Zephyrhills Fire Fax- 813 - 780 0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> ,,.,.= <br /> Owner's Name Wio_i.?/YAQ AL Owner's Phone Number j/3 1 1 0317 <br /> Owner's Address 3 7815 /5 . <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> Job Address ,37R/5 /,4' ,Vve Lot# <br /> Sub Division Parcel # <br /> h Bio- Hazard Waste Storage - ANNUAL J ] Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier II or RQ Fa " ANNUAL <br /> ri Controlled Bum I Hood Installation <br /> Emergency Generator < 30 kw I LP /Natural Gas - Installation `12 <br /> n <br /> n Emergency Generator> 30 kw I I LP /Natural Gas- ANNUAL -ale 1 <br /> I — I Fire Protection Maintenance - ANNUAL 71 Places of Assembly -ANNU <br /> - -- semi ( (� tither <br /> Sprinkler_,,_ M fd ❑ ❑ n Recreational Bum <br /> c_t =ire Alarm ❑ ❑ I n Sparklers <br /> Hood Cleaning ❑ ❑ ❑ I ( n Sprinkler System Installations <br /> Hood Suppression E ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation I-1 Torch Roofing/Tar Kettle <br /> I I Fire Pumps n Waste Tire Storage ANNUAL <br /> ri Fire Works <br /> n Flammable Application- ANNUAL ( 1 Valuation of Project <br /> n Fuel Tanks <br /> Q Other: I <br /> Contractor Company _ <br /> Signature I•' ` 1 Registered oft= Fee Current Twain <br /> Add <br /> License # <br /> ELECTRICIAN Company <br /> Signature Registered Y / N J Fee Current I Y / N I <br /> Address I 1 <br /> License # <br /> PLUMBER Company <br /> Signature Registered Y / N J Fee Current I Y / N <br /> Address I I License # <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address 1 I License # <br /> OTHER Company <br /> Signature Registered Y / N j Fee Current I Y / N j <br /> Address <br /> License # <br /> Directions: <br /> , <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 (httpJ /appraiser.pascogov.com) <br />