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813 -780 -0020 City of•Zephyrhills Fire -.• Fax- 813 -780 -0021 <br /> - <br /> Permit Application _ <br /> Date Received Phone Contactfor Permit 1 <br /> Owners Name y a v #,# Owner's Phone Number a73 1777 7asz <br /> Owner's Address 0 y r- M/20 2749 /h , <br /> Fee Simple Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> n Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Burn 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 /> Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> Iutrlyl ISemiI Gail Uther <br /> Sprinkler El ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm El ❑ ❑ ❑ I Sparklers <br /> Hood Cleaning ❑ 9l ❑ n Sprinkler System Installations <br /> Hood Suppression 3 ❑ A ❑ I 1 n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> I I Fire Pumps n Waste Tire Storage ANNUAL <br /> 7 Fire Works <br /> Flammable Application- ANNUAL I I Valuation of Project <br /> I - 1 Fuel Tanks <br /> Q Other: I <br /> Contractor Company <br /> Signature Registered Y / N I Fee Current 1 Y / N <br /> Address I I License # I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Current I Y / N <br /> Address I I License # <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N <br /> Address I I License # <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current 1 Y / N <br /> Address 1 I License # I <br /> OTHER 11111, Company .� r p '„ ha <br /> Signature N P Registered g 7zu Fee Current r�� <br /> Address License # Lj �1 " "T';71111111.' <br /> Directions: <br /> Fill out application completely. <br /> Owner 8& 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 />