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813 - 780 -0020 City of.Zephyrhills Fire Fax - 81 3 750 -0 021 <br /> Permit Application <br /> F <br /> Date Received -- / / - / V Phone Contact for Permit 2 2T 3 I ti o <br /> Owner's Name Owner's Phone Number - � 1 <br /> Owners Address <br /> •Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee SimpleTrtleholder Address I <br /> Job Address L✓? , (4,/ 7 /s J J O 6,1( (3'/ vii Loth Y w <br /> Sub Division Parcel# <br /> n Bio-Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Comm Exhaust Kftchen 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 /> n Emergency Generator> 30 kw n Places of Assembly-ANNUAL <br /> n Fire Protection Maintenance- ANNUAL n Recreational Bum <br /> rri7 )Semi I UM Other <br /> Sprinkler El ❑ ❑ ❑ n Sparklers <br /> Fire Alarm El ❑ ❑ ❑ 1 I n Sprinkler System Installations <br /> Hood Cleaning El ❑ ❑ ❑ 1 I n Standpipes (Sprinkler Sys) <br /> Hood Suppression ❑ �` ❑ l I n Torch Roofing/Tar Kettle <br /> n Fire Alarm Installation /� n Waste Tire Storage ANNUAL <br /> n Fire Pumps <br /> n Fire Works <br /> n Flammable Application- ANNUAL i I Valuation of Project <br /> n Fuel Tanks <br /> In Other I <br /> Contractor Company L • � L <br /> � <br /> � � . <br /> Signature Registered 11611E1 9 �'1 Fee Current <br /> Address ( License # <br /> ELECTRICIAN Company <br /> Signature Registered Y / N j Fee Current I Y / N <br /> Address I License # <br /> PLUMBER Company <br /> Signature Registered Y / N I Fee Current I Y / N I <br /> Address I <br /> 1 license* <br /> MECHANICAL Company <br /> • <br /> Signature Registered Y / N j Fee Current I Y/ N I <br /> Address ) <br /> I License* <br /> OTHER Company J <br /> Signature Registered Y / N I Fee Current I Y / N I <br /> Address <br /> .,_.. _:.. - License # ! <br /> - - _ . of <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 />