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813-780 -0020 City of Zephyrhills -Fire. -ts'C / 0/ S Z' Fax- 813 - 780 -0021 <br /> Permit Application <br /> 4.- <br /> Date Received " � Phone Contact for Permit , <br /> Owner's Name I P45( i C ju cam, .4� t fig a --- Owner's Phone Number 1 1 1 1 1 <br /> kner'sAddress - 7 A'3s- G-etu j10 ZG ?,/4, i0 F e <br /> Fee Simple Titleholder Name I Titleholder Phone Number I <br /> Fee Simple Titleholder Address I <br /> Job Address 7 /r3 fr LT if u Nub 2/1r1 f I , . <br /> Lot* <br /> Sub Division Parcel # <br /> El 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 /> I Emergency Generator < 30 kw f ] LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> (;j j semi' ujj Uther <br /> Sprinkler D • ❑ ❑ I I Recreational Bum <br /> Fire Alarm De ❑ IS. f I ri Sparklers <br /> Hood Cleaning ■ • ❑ ❑ f I n Sprinkler System Installations <br /> Hood Suppression JJ ❑ ❑ ❑ f I [ ] Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> F-7 Flammable Application- ANNUAL I I Valuation of Project <br /> n Fuel Tanks <br /> In Other: I <br /> Contractor Company �i �j s �'t C zr CI r <br /> Signature Registered Y / N Fee Current Y / N <br /> Address 3 Z �'1/ <br /> 1/.- Arc iI W 0 4 I License # !s'F ( 623 I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Current I Y/ N <br /> Address I I License # I <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address i I License # I <br /> MECHANICAL Company <br /> Signature <br /> Registered Y/ N J Fee Current I Y/ N j <br /> Address I I License # I I <br /> OTHER I Company <br /> Signature I Registered Y/ N _I Fee Current I Y/ N I <br /> Address I I <br /> I License # I <br /> Directions: l <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 (httpJ /appraiser.pascogov.com) <br />