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813-780-0020 <br /> City of Zephyrhills Fire. I rya( Fax - 813 - 780 -0021 <br /> • <br /> Permit Application l <br /> Date Recer d o - Phone Contact for Permit <br /> Owners Name V/, • / 4 j 1 Owner's Phone Number 1 q 11 go y 1 I /o6? <br /> Owner's Address 74 r 601-u g L v <br /> Fee. Simple Titleholder Name Titleholder Phone Number <br /> 1 <br /> Fee Simple Titleholder Address <br /> Job Address 7 6 S1 6,rri L-L S4 v a , Lot # <br /> Sub Division I Parcel # I <br /> usessonesestammenatam V <br /> n 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 Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> (UtrIyI !berm' WA L•iliT1 <br /> Sprinkler El ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm 0 ❑ ❑ ❑ I 1 El Sparklers <br /> Hood Cleaning E ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression IXI ❑ X ❑ I I n Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps . n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL I Valuation of Project <br /> • Fuel Tanks <br /> n Other: I <br /> Contractor 1r Ar an <br /> P Y .�/ G` r . a/ t ,, Company �'� r -A . c <br /> Signature /' Registered Kell Fee Current Y / N <br /> Address License# I S"96S000031990 I <br /> ELECTRICIAN Company I <br /> Signature Registered Y / N I Fee Current I Y/ N I <br /> Address ( I License # <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current I Y/ Ni I <br /> Address <br /> I License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N _I Fee Current I Y/ N I <br /> Address I <br /> 1 License # <br /> OTHER Company <br /> Signature Registered Y/ N I Fee Current I 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 />