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813- 7b0 -Q020 City of Zephyrhills Fire Fax- 813 - 780 -0021 <br /> Permit Application <br /> Date Received l Phone Contact / <br /> for Permit I ,3 I ( p,„3. 1 l ,2p p <br /> Owner's Name C J l T1 6 Cc " z e p hy r 1'(, lIs I Owner's Phone Number 1 I l 1 <br /> Owner's Address 5 3 36 Sr H 3 1l P b y r A . lb r j' ??,s,V 2 <br /> Fee Simple Titleholder Name Titleholder Phone Number I I <br /> Fee Simple Titleholder Address I <br /> _...::...; .. ,, :f :;n4 s,�` ,ixLiMqVk . Rash." , M.Za.. ' `. Kt-F.Z ER:Aiti t ,Y..�:i ',,e' „ atn li .. =:: r: nt.Y. •K ;' §MV�"^ _ .. lck. .a.0;g' d r� .,:, <br /> Job Address 3730 1 Chcipe 1 di" 1 Loop , L I Lot # <br /> Sub Division Parcel # 0 3– .26 GO /Q- /DGa -(2210 <br /> n Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> El 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 /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> [ I Fire Protection Maintenance - ANNUAL I 1 Places of Assembly- ANNUAL ., <br /> IMITTyl Semi ( (a Other <br /> Sprinkler 71 ❑ ❑ n Recreational Bum <br /> Fire Alarm E ❑ ❑ ❑ I I n Sparklers <br /> Hood Cleaning 0 ❑ ❑ ❑ I ! n Sprinkler System Installations <br /> Hood Suppression n ❑ ❑ ❑ I 1 n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> H Fire Pumps 1 Waste Tire Storage ANNUAL <br /> Fire Works <br /> 7 Flammable Application- ANNUAL I I Valuation of Project <br /> I Fuel Tanks <br /> IIII Other: MI <br /> 14�ii.a � :, -k�.�. n .. .�. a�� - ....,ter , ,y <br /> Contractor ■ � ■� ri L � ` ` �y, Tens' I <br /> Signature Registered Q N Fee Current I Y / N <br /> Address .1e/rill tlira er" Th License # I fj z f 7 OOU 11 q' 2 <br /> ELECTRICIAN Company <br /> Signature Registered Y / N j Fee Current I Y/ N J <br /> Address I <br /> I License # <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N <br /> Address I . <br /> I License # <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current 1 Y/ N <br /> Address I <br /> 1 License # I I <br /> OTHER Company <br /> Signature . Registered Y/ N J Fee Current I Y/ N I <br /> Address <br /> License # I <br /> Directions: <br /> ,et �«„- :. ea,�cm_x., — ,w..a a .:ra::.,a.,.e«.wa i.s r: .a�.r .=c..,w > a - .x•.. .a�.:; s w .. s..'.: a a aa=.° s,:- ..:a ate'. :. �s,,. .a -: i,.; m.iw;..m�»,,....aa..,, - s:.. 1 <br /> ion <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 />