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B1S,+7B0 -0020 City of ZephyrhillsFire�. Fax -813- 7e0-0021 <br /> Permit Application <br /> Date Received 1 1 - Phone Contact for Permit <br /> Owner's Name I ,f ly21 j &_ Jfr I Owner's Phone Number , `• ' 4t el_ <br /> Owner's Address GPcl /ifs /22 ZAV <br /> Fee SimpleTitieholder Name 1 I Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> Lot # <br /> Job Address <br /> Parcel # <br /> Sub Division ! <br /> El Bio-Hazard Waste Storage - ANNUAL Fumigation Tent <br /> I 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 I Emergency Generator> 30 kw 1 1 LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL I ' Places of Assembly- ANNUAL <br /> I Carly I lsemiI rall lutner <br /> Sprinkler n ❑ ❑ ❑ II Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I I I I Sparklers <br /> Hood Cleaning ❑ ,g'' ❑ I I ) I Sprinkler System Installations <br /> Hood Suppression S. ❑ o Q ❑ .I 1 1 1 Standpipes (Sprinkler Sys) <br /> I Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> I I Fire Pumps n Waste Tire Storage ANNUAL <br /> l I Fire Works <br /> Flammable Application- ANNUAL 1 ( Valuation of Project <br /> n Fuel Tanks <br /> El Other: I <br /> Contractor Company <br /> Signature Registered Y / N I Fee Current Y / N I <br /> Address 1 ( License # I I <br /> ELECTRICIAN Company <br /> Signature Registered Y / N I Fee Current I Y / N 1 <br /> Address I I . , License # I <br /> PLUMBER Company <br /> Signature Registered Y / N I Fee Current I Y / N I <br /> Address I I License # <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address I . License # I <br /> OTHER Company „ 4' P 7 «C. <br /> Signature Registered W Fee Current •�, la <br /> Address License # : Y' //t, Lr <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 />