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813-780-0020 ,e7. 7 n,� City of Zephyrhills "Fire Fax - 813-780 -0021 <br /> l / / . Permit Application C } <br /> Date Received / 6; /� D /© Phone Contact for Permit ( ?(3 ...c9-3 J / 3S7 <br /> L T1 .2LO -HO IRA/7i T/7 i3 -5 . 93.5 <br /> Owner's Name /�� BOX Owner's Phone Number <br /> Owner's Address P.0. O/� g 73g /79,/i/99 r -z 33 674 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address 1 I <br /> ,101111.0P"' .�, ; _ ;�W � - .iz.,4,.'� .� M. t'. �� mac•. � , .:az .,.�� r ;- .a�„.�:r`":a., �:�.• af"a� is <br /> Job Address / , ; / " _.. / _ 1 Lot # <br /> Sub Division rol <br /> Parcel # <br /> f'u ^.. r r:w i,�Wit. �?6s�,✓?.z,aas -,* -,�, „_ -..- '— `w»w.- , .r=�r a - ..c.e:a, ; «- 'ra- .,.mss a .rs,zsri.c�«r: - ....,e +ewr��, _-'e i6 ?J <br /> h Bio-Hazard Waste Storage - ANNUAL I I Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct r Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I Controlled Bum n Hood Installation <br /> I Emergency Generator < 30 kw ( LP /Natural Gas - Installation <br /> I Emergency Generator> 30 kw ( ( LP /Natural Gas - ANNUAL Sale --- .- -- -- ------- <br /> I I Fire Protection Maintenance - ANNUAL I Places of Assembly- ANNUAL ~ N <br /> IUt"yI Ibemi) Uther <br /> Sprinkler n ❑ ❑ ❑ I I Recreational Bum f <br /> Fire Alarm ❑ ❑ ❑ I • 1 l I Sparklers ; / <br /> 0 6 0 ' <br /> Hood Cleaning l ID 1 1 I I Sprinkler System Install ions <br /> Hood Suppression El ❑ ❑ ❑ I • .I I I Standpipes (Sprinkler Sy <br /> Fire Alarm Installation I ( Torch Roofing/Tar Kettle k , IF <br /> Fire Pumps Waste Tire Storage ANNUAL C <br /> n Fire Works <br /> I Flammable Application- ANNUAL I I Valuation of Project <br /> I Fuel Tanks <br /> I Other: I I <br /> Contractor , Company 16(//' <br /> /V /e ic /Ccs I <br /> Signature u Registered Y / N 1 Fe e Current Y / N I <br /> Address I I License # I <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N J <br /> Address I I License # I I <br /> PLUMBER Company I <br /> Signature Registered Y / N I Fee Current 1 Y / N 1 <br /> Address I 1 License # I <br /> MECHANICAL Company <br /> Signature Registered Y / N 1 Fee Current I Y / N J <br /> Address I I License # 1 <br /> OTHER Company I <br /> Signature Registered Y/ N 1 Fee Current I Y/ N I <br /> Address 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 />