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813 -780 -0020 City of.Zephyrhills Fire Fax- slsa60-0021 <br /> Permit Application <br /> Date Received 0 , -/ 2-/ • Phone Contact for Permit <br /> Owner's Name W41._ // 4/ L 11 t S Owner's Phone Number _ <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number , <br /> Fee Simple Address I <br /> Job Address Lot* <br /> Sub Division Parcel•# <br /> l aw.,, .. ,.:; :.. .:..:�N:- ,..:.. ... ,.. .;., .:.... ... ... :. ... .. ..:. ..f. ,..� fa. - al's -_- - •.......... Via... ... ..... .. <br /> FT Bio-Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Comm Exhaust Kitchen Hood/Duct n Hood Installation <br /> n Controlled Bum n LP /Natural Gas - Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale <br /> Emergency Generator> 30 kw n Places of Assembly-ANNUAL <br /> Fire Protection Maintenance - ANNUAL n Recreational Burn <br /> t y emr aaj Other <br /> Sprinkler E ❑ ❑ l°al n Sparklers <br /> Fire Alarm El ❑ ❑ ❑ I n Sprinkler System Installations <br /> Hood Cleaning El ❑ ❑ ❑ 1 1 El Standpipes (Sprinkler Sys) <br /> Hood Suppression ❑ ❑ ❑ I I n Torch Roofing/Tar Kettle <br /> n Fire Alarm Installation = Waste Tire Storage ANNUAL <br /> I -1 Fire Pumps <br /> n Fire Works <br /> n Flammable Application - ANNUAL • 1 I Valuation of Project <br /> n Fuel Tanks <br /> Q Other. I I <br /> eguaimmessmairr <br /> Contractor Company I <br /> Signature <br /> 7.- Registered Y / N 1 Fee Current I Y/ N <br /> Address I I License# <br /> ELECTRICIAN Company <br /> Signature Registered Y / N J Fee Current . 1 Y / N I <br /> Address I I License # <br /> PLUMBER <br /> • <br /> Company I <br /> Signature Registered Y / N 1 Fee Current I Y/ N <br /> Address I License # <br /> MECHANICAL Company I <br /> Signature Registered Y / N I Fee Current I Y/ N <br /> Address I I license # <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current Y/ N <br /> - <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 (http: / /appraiser.pascogov.com) <br />