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813 -780 -0020 City ofZephyrhills'Fire.- Fax -813 -780 -0021 <br /> Permit Application <br /> Date Rectel j " / O Phone Contact for Permit J 1 1 1 <br /> Owner's Name ?..& f . //i2 C J G✓/, j? •( Owrier's Phone Number <br /> Owner's Address <br /> Fee Simple Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> Job Address 4/330 — 0 c: Lot # <br /> Sub Division Parcel # <br /> n Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> I 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 /> I - 7 Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> I Fire Protection Maintenance - ANNUAL • I I Places of Assembly- ANNUAL l <br /> �Utrly� Semi) Oa Other C <br /> Sprinkler E ❑ ❑ n Recreational Bum --- <br /> Fire Fire Alarm n " ` ❑ ❑ ❑ I I Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression n ❑ ❑ ❑ .1 I n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> I Fire Pumps n Waste Tire Storage ANNUAL <br /> I Fire Works <br /> I Flammable Application- ANNUAL , I Valuation of Project <br /> I Fuel Tanks <br /> n Other: I <br /> Contractor Company <br /> Signature , ' Registered Y / N I Fee Current I Y / N <br /> Address `" <br /> License # <br /> ELECTRICIAN Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address I License # I <br /> PLUMBER Company <br /> Signature Registered Y / N , Fee Current 1 Y / N <br /> Address I <br /> I License # <br /> MECHANICAL Company <br /> Signature Registered Y / N Fee Current I Y / N I <br /> Address I I License # I I <br /> OTHER Company <br /> Signature Registered Y/ N j Fee Current 1 Y/ N I <br /> Address <br /> 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 />