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813 -780 -0020 City of.Zephyrhills Fire Fax - 813 - 780 -0021 <br /> 'Permit Application <br /> Date Received Phone Contact for Permit Ir. s 11 (51, f <br /> Owner's Name l r / ee/ I A . - 2 7-e , I Owner's Phone Number l g! 3 I7 Jr 17 I 1 <br /> Owner's Address ,j %`r` Lore- /4,i- J) <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee SimpleTitleholder Address I <br /> :. <br /> Job Address 3 q ti L. ri d/a r.., D.- 4 - t Lot # <br /> Sub Division I Parcel # <br /> n Bio- Hazard Waste Storage - ANNUAL = Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct . n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Controlled Bum = Hood Installation <br /> Emergency Generator < 30 kw El LP /Natural Gas - Installation <br /> El Emergency Generator > 30 kw I LP /Natural Gas - ANNUAL Sale 1 /7 <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL / / <br /> � ",7 'Semi' raj ... <br /> Sprinkler n ❑ ❑ ❑ 1 Other /1 1 n Recreational Bum \ <br /> Fire Alarm ❑ ❑ ❑ I 1 n Sparklers q ( i <br /> Hood Cleaning n ❑ ❑ ❑ I I n Sprinkler System Installa • ns / <br /> Hood Suppression El ❑ ❑ ❑ I 1 n Standpipes (Sprinkler S ) �/ 111 <br /> Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> 0 <br /> Fire Pumps El Waste Tire Storage ANNUAL <br /> n Fire Works <br /> Flammable Application- ANNUAL 1 ( Valuation of Project <br /> F T Fuel Tanks <br /> n Other: <br /> Contractor Pe♦- .r,� <br /> Signature <br /> • Registered Y/ N Fee Current I Y/ N j <br /> Address I I License # I <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I 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 Registered Y/ N I Fee Current I Y/ N <br /> Address I I License # I I <br /> OTHER Company <br /> Signature Registered Y / N I Fee Current Y/ N I <br /> Address I 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 />