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813 - 780 -0020 City ofZephyrhills Fire it ( 0548 Fax -813- 780-0021 <br /> Permit Application v <br /> Date Received • <br /> Phone Contact for Permit I I i I <br /> Owner's Name I v' 0 , Z) \A. W\ 5 . <br /> � /►� � � � /� I Owner's Phone Number � 1 ', 1 rj I 1 \\ C 3I <br /> Owners Address l l�„ � l} lJ Cs..\,,� � \vCx 7.4 V ■AiZ‘A,lk[; ` <br /> Fee Simple Titleholder Name I I Titleholder Phone Number I 1 1 1 J <br /> Fee Simple Titleholder Address I <br /> max i s tommasmazonsamignammwr <br /> Job Address <br /> I Lot # I <br /> Sub Division I <br /> maisarmassisse <br /> Parcel # <br /> n Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> (i Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Comm Exhaust Kitchen Hood/Duct <br /> n Controlled Bum I Hood Installation <br /> I:=1 Emergency Generator < 30 kw n LP/Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP/Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL <br /> f 1 <br /> • Places of Assembly-ANNUAL <br /> . I� La;a 'semi! ®I timer I <br /> Sprinkler ❑ ❑ ❑ <br /> ❑ Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ 1 1 Sparklers <br /> Hood Cleaning El El El I I Sprinkler System Installations <br /> Hood Suppression ❑ <br /> E I Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation <br /> ri Torch Roofing/Tar Kettle <br /> Fire Pumps <br /> Fire Works Waste Tire Storage ANNUAL <br /> Flammable Application- ANNUAL <br /> Fuel Tanks I I Valuation of Project <br /> ill • i er•. <br /> Contractor <br /> Signature ny IM <br /> Address �� N i Y / N Fee Current Y / N <br /> ELECTRICIA a— License # <br /> Signature Company <br /> Address Registered Y / N Fee anent Y / N <br /> PLUMBER License # <br /> Signature Company <br /> Address Registered Y / N Fee Current Y / N <br /> MECHANICAL License # <br /> Signature Company <br /> Address Registered Y / N Fee Current MEI <br /> OTHER License* <br /> Signature Cony <br /> Address Registered Y / N Fee Current MUM <br /> Directions: License # <br /> art aPPilCation 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.(Mecfanical work over $5000) <br /> Supply two (2) sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. <br /> Parcel # - obtained from Property Tax Notice (httpJ /appraiser.pascogov.com) <br />