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813 - -0020 City ofZephyrhills Fire -- c . Fax- 813 -780 -0021 <br /> Permit Application <br /> - <br /> Date Received - Phone Contactfor Permit <br /> Owner's Name SL 'e ee; / Ho /444 4j <br /> Plc; / {. S 7 ? r s' Owner's Phone Number <br /> Owners Address 3�6?O L 4 N5;4 - fi <br /> , --e. Z-e f , Ps-/ f__—/ <br /> 6 <br /> Fee SimpleTitieholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address J <br /> Job Address Lot# <br /> Sub Division Parcel # <br /> n Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> J I Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum Jn 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 /> n Fire Protection Maintenance - ANNUAL • 1 / 1 Places of Assembly- ANNUAL <br /> 1Utrly1 Semi' raj other <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ J 1 n Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ l J ( Sprinkler System Installations <br /> Hood Suppression n ❑ ❑ ❑ J J n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> Flammable Application- ANNUAL I 1 Valuation of Project <br /> n Fuel Tanks <br /> 0 Other: J <br /> Contractor IA 7 Company <br /> Signature /`/ Registered Y / N Fee Current I Y / N <br /> Address ( License # I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N J Fee Current 1 Y/ N <br /> Address J J License # <br /> PLUMBER Company <br /> Signature Registered Y/ N j Fee Current I Y / N I <br /> Address 1 I License # <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current 1 Y / N <br /> Address J J License # <br /> OTHER Company <br /> Signature Registered Y/ N j Fee Current I Y/ N j <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 (httpJ /appraiser.pascogov.com) <br />