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813-780 -0020 City of Zephyrhills Fire ff 1 e i f( Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received I I Phone Contact for Permit I I <br /> Owner's Name �L oef -G l onCautf gt 1 h 3 <br /> C1 . 4.. <br /> Owner's Address T 33 ND0 i ' Z � � k lk VL 335 -p <br /> Fee Simple Titleholder Name ) Titleholder Phone Number ralal Will 0_,OOD <br /> Fee Simple Titleholder Address I <br /> Job Address I Lot # <br /> Sub Division Parcel # <br /> 0 Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I <br /> Controlled Burn El Hood Installation <br /> El Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL Places of Assembly- ANNUAL <br /> IQtrlyI ISem(1 I^"' I Other <br /> Sprinkler 0 ❑ ❑ ❑ n Recreational Burn <br /> Fire Alarm n ❑ ❑ ❑ I 1 [ Sparklers <br /> Hood Cleaning 0 ❑ ❑ ❑ I 1 0 Sprinkler System Installations <br /> Hood Suppression n ❑ ❑ ❑ I 1 I1 Standpipes (Sprinkler Sys) <br /> Pi Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> Flammable Application - ANNUAL I I Valuation of Project <br /> Fuel Tanks <br /> - . t% <br /> Al 9 ther: <br /> Contractor Com an� <br /> Signature � �t� t i / i �`/ Re gistered Y/ N I Fee Current I 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 License # <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 <br /> I License # <br /> OTHER <br /> Company I <br /> Signature Registered Y / N I Fee Current 1 Y/ N I <br /> Address I <br /> I License # <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 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 /> 533S <br /> 2 hL h: II' 4-(- 3 35/ <br />