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813- 780 -0020 City of Zephyrhills Fire. Fax - 813 -780 -0021 <br /> Permit Application <br /> Date Received 1 0 Phone Contact for Permit Mg. Lt <br /> Owner's Name f �/ © 4 ciC, / �r X� Owner's Phone Number ( 1 1 1 1 I <br /> Owners Address <br /> Fee Simple Titleholder Name Titleholder Phone Number 1 1 1 1 <br /> Fee Simple Titleholder Address I <br /> Job Address - 70,5 — ° 6'W2// 306d . Lot # I <br /> Lot # � <br /> Sub Division <br /> Parcel # <br /> - - - - . , _at; -, .- - - - _,�L" a s_�.; .rc r:� , !3�'39b et. °�ri e.�'u 7.. r1<.r , - .E��gl4� Y ✓> <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 I I Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> El Emergency Generator > 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> IUtnyl 'Semi I (A�rI Other <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I I I I Sparklers <br /> Hood Cleaning n ❑ 13 CI Sprinkler System Installations <br /> Hood Suppression V t ❑ X ❑ I I I I Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps I I Waste Tire Storage ANNUAL <br /> I I Fire Works <br /> I1 Flammable Application- ANNUAL I I Valuation of Project <br /> I - 1 Fuel Tanks <br /> I Other I <br /> Contractor ..„77 411WPOr �� P454 Pi rt #41..e...4 i-er 1 <br /> Signature <br /> Registered Y / N I Fee Current 1 Y/ N <br /> Address I 1 1701 £ G- -4 — 6 - 6 Lw6.- -T _ .1 1 License # <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Current I Y / N <br /> Address I I License # I <br /> PLUMBER Company I <br /> Signature Registered Y/ N j Fee Current I Y/ N <br /> Address I f <br /> I License # <br /> MECHANICAL Company I <br /> Signature <br /> Registered Y / N I Fee Current 1 Y / N J _ <br /> Address ( I License # I I <br /> OTHER Jar <br /> Company <br /> Signature Registered Y/ N . 1 Fee Current I Y/ N I <br /> Address License # <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 />