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• 813.480 -0020 City of.Zephyrhills Fire Fax- 813 -780 -0021 <br /> -Permit Application <br /> Date Received Phone Contact for Permit 803 <br /> :.. 76 9.56 <br /> Owner's Name I B/� Ciff,te I Owners Phone Number I 3s2. 1526 I 261r'f <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee SimpleTitleholderAddress I <br /> Job Address 4Af [7/ie &va <br /> _ Lot # <br /> Sub Division Parcel # <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 /> El Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas- Installation <br /> n - <br /> Emergency Generator 30 kw n L /Na tural Gas - ANNUAL Sale - <br /> Fire Protection Maintenance - ANNUAL Places of Assembly -ANNUA <br /> r y Semi) pciT1 Other � / r <br /> Sprinkler El ❑ ❑ ❑ n Recreational Bum 0 `/ �L <br /> Fire Alarm n ❑ ❑ ❑ I n Sparklers <br /> / 4'9 <br /> Hood Cleaning CI ❑ ❑ ❑ I n Sprinkler System Ins ations <br /> Hood Suppression 0 ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> El 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 ' Valuation of Project <br /> Fuel Tanks <br /> 0 Other. I <br /> Contractor Company <br /> Signature / `(j Registered I Y / N Fee Y / N <br /> Address ( ( License # <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N 1 Fee Current I Y/ N <br /> Address I License #. I <br /> PLUMBER Company <br /> Signature Registered Y / N - I Fee Current I Y / N I <br /> Address I I ' License # I I <br /> MECHANICAL Company <br /> Signature Registered Y / N . 1 Fee Current 1 Y / N <br /> Address I I License # <br /> OTHER Company <br /> Signature Registered Y/ N J Fee Current I Y/ N 1 <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 (littpJ /appraiser.pascogov.com) <br />