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813780 -0020 City ofZephyrhills Fax - 813 -780 -0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit J I <br /> Owner's Name ./fi�� V�p� � ,/ib — � c,vrr £ Owner's Phone Number y,; ,134.f <br /> Owner's Address S V Z (i .24: 2epltyi -L II FC <br /> Fee Simple Titleholder Name / Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> - 1ni� .,_.. n.. ._. .. ae ..., ..., ... - .. ..., .. _ -_ «.. -.. a . -.♦ = 1.<9--s'& ,. n. .'.iii, <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> 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 I LP /Natural Gas - Installation <br /> In Emergency Generator> 30 kw LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL I I Places of Assembly - ANNUAL <br /> 1Qtriyl (semi ( r74711 other <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I n Sparklers <br /> Hood Cleaning ❑ g ❑ I I Sprinkler System Installations <br /> Hood Suppression ❑ XL ❑ I I n Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation Torch Roofing/Tar Kettle <br /> Fire Pumps Waste Tire Storage ANNUAL <br /> Fire Works <br /> I Flammable Application- ANNUAL J ( Valuation of Project <br /> n Fuel Tanks <br /> In Other: I <br /> Contractor Company <br /> Signature Registered Y / N j Fee Current Y / N <br /> Address I I License # <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Current I Y / N I <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 J Fee Current I Y ' / N I <br /> Address 1 I • License # <br /> OTHER Company <br /> 411111/ r L L <br /> Signature ) Q/!/' Registered Fee Curre -/ mom <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 1014 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br />