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813-7 0 -0020 City of. Zephyrhills Fire Fax - 81 3 780 -0 021 <br /> Permit Application <br /> Date Receiv <br /> —� <br /> use ed Phone Contact for Permit f /0 k, . <br /> Owner's Name Owner's Phone Number <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Address I <br /> Job Address (.Oel -3 _)oh✓i 'i !vv. ) `? -fJ 6-4? 1t g(iV4/ Lot* , <br /> Sub Division Parcel# <br /> n Bio-Hazard Waste Storage - ANNUAL = Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Comm Exhaust Kitchen Hood/Duct n Hood Installation <br /> Controlled Bum n LP /Natural Gas - Installation <br /> n Emergency Generator < 30 kw n • LP /Natural Gas - ANNUAL Sale <br /> F - 1 Emergency Generator > 30 kw n Places of Assembly- ANNUAL <br /> = Fire Protection Maintenance - ANNUAL = Recreational Burn <br /> t y emi Uni Other <br /> Sprinkler ❑ ❑ ❑ n Sparklers <br /> Fire Alarm _ ❑ ❑ ❑ l n Sprinkler System Installations <br /> Hood Cleaning ❑ Iff ❑ I 1 [] Standpipes (Sprinkler Sys) <br /> Hood Suppression ❑ ❑ ❑ ( jJ Torch Roofing/Tar Kettle <br /> n Fire Alarm Installation ED Waste Tire Storage ANNUAL <br /> n Fire Pumps <br /> Fire Works <br /> n Flammable Application- ANNUAL I Valuation of Project <br /> n Fuel Tanks <br /> E Other. I I <br /> Contractor , :' - >— Company i s , r). ty,, • f'e " / . <br /> Signature Registered ream Fee Current rang' <br /> Address I I License # I <br /> ELECTRICIAN Company <br /> Signature Registered Y / N j Fee Current I Y / N <br /> Address I I License* I I <br /> PLUMBER Company I <br /> Signature f Registered Y / N I Fee Current I Y / N I <br /> Address 1 I License* I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N I Fee Current I Y 1 N I <br /> Address 1 I License # I <br /> OTHER Company I <br /> Signature Registered Y / N I Fee Current Y / N <br /> Address License # 1 <br /> ._ .:_ .,..„. .:. . . _ __, . _ _ a <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 52500, a Notice of Commencement is required (Mechanical work over $5000) <br /> Supply two (2) sets of drawings with applicable documentation • <br /> Allow 1 0 -14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br />