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813 - 780 -0020 City of Zephyrhills Fire Fax -813 -780 -0021 <br /> Permit Application <br /> Date Received 6F1 Phone Contact for Permit <br /> Owner's Name kii9ai?, Owner's Phone Number I <br /> Owner's Address 710 C� G 1 6108 <br /> 1 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> vea.' r:ir:ow�.ea" .. i.ma • t &o f ;c s;: . ,,,I aw 'r' '€w it w , :; - ':'^ Wi t" tgua:mimataw ozkv §aaza a ' w2mg w pa <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 Bum 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 /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> IQtrly) emi 7 "" 1 Other <br /> Sprinkler n ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ 1 ( n Sparklers J�� b v S_ 1 <br /> Hood Cleaning ��❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression 0 ❑ ❑ ❑ 1 1 n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch RoofinglTar Kettle <br /> El Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> FT Flammable Application - ANNUAL l I Valuation of Project <br /> n Fuel Tanks <br /> n Othe : <br /> Contractor � j Company <br /> Signature / ,. _ [� Registered Y / N I Fee Current I Y / N j <br /> Address I License # <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address 1 License # I <br /> PLUMBER Company <br /> Signature Registered Y/ N ,I Fee Current I Y/ N I <br /> Address I <br /> I License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N ,I Fee Current I Y / N I <br /> Address I I License # <br /> OTHER Company I <br /> Signature Registered Y/ N Fee Current I Y / N I <br /> Address I I License # <br /> O .e4.Va ,,,,, .: ..,es .... u... �s .4,41 wm. ,m ',uasa. ,.a.,,. , . o--, ..,u «. k,,,, :,...,, ... ,.. ams, - . . ,..,.,s.ss« ,,,....,.. .../?S <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 clays for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br />