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813-780 -0020 City of.Zephyrhills Fire Fax- 81376D -0021 <br /> Permit Application <br /> Date Received t,' - a , U Phone Contact for Permit <br /> Owner's Name \/■,Ve—, Owner's Phone Number <br /> e - 31, ((2 ) I J ,1 • <br /> Owner's Address J % .' '# • ►` a ? d —\ <br /> •Fee Simple Titleholder Name • Titleholder Phone Number 8V? <br /> Fee SimpleTitleholder Address J r j <br /> elitiffittilitaller - <br /> - <br /> Job Address - Lot - <br /> Sub Division Parcel•# <br /> T Bio-Hazard Waste Storage - ANNUAL = Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> • <br /> Comm Exhaust Kitchen Hood/Duct = Hood Installation <br /> n Controlled Bum n LP /Natural Gas - Installation <br /> Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale • <br /> Emergency Generator> 30 kw Places of Assembly-ANNUAL . 01 <br /> 1 Sul Fire Protection Maintenance - ANNUAL = Recreational Bum ._ r t y .Isemll ( Other <br /> Sprinkler I ❑ ❑ ❑ n Sparklers <br /> �_ Fire Alarm El ❑ ❑ ❑ I ( n Sprinkler System Installations • <br /> Hood Cleaning = ❑ ❑ ❑ ) 1 EJ Standpipes (Sprinkler Sys) <br /> Hood Suppression E1 ❑ ❑ ❑ I I L Torch Roofing/Tar Kettle <br /> I Fire Alarm Installation = Waste Tire Storage ANNUAL <br /> 1 Fire Pumps <br /> Fire Works <br /> n Flammable Application - ANNUAL ! ( Valuation of Project <br /> n Fuel Tanks , <br /> E Other. J <br /> Contractor ( Company <br /> Signature ,,(V„..._ Registered Y / N 1 Fee Current J Y / N <br /> Address J - I - License* J <br /> ELECTRICIAN Company <br /> Signature Registered Y / N I Fee Current .1 Y/ N 1 <br /> Address I License* I <br /> PLUMBER • Company I <br /> • Signature Registered Y / N J Fee Current J Y / N. J <br /> Address J - • I License # I <br /> MECHANICAL Company I • <br /> Signature - Registered Y/ N j Fee Current J Y/ N <br /> Address J I - License* I <br /> OTHER Company J <br /> Signature • , Registered Y/ N I Fee Current 1 Y/ N I <br /> Address License # <br /> Directions: - - <br /> . Fill out application completely. <br /> Owner 8 Contractor sign back of apph c ttion, notarized (Or, copy of signed contract with owner) <br /> if over 52500, a Notice of Commencembnt is required (Mechanical work over $5000) <br /> Supply two (2) sets of drawings with adpIIcable documentation <br /> Allow 10 - days for review after Submittal date. Parcel # - obtained from Property Tax tapfiee (htep: /fappraieer.pascogov.com) <br />