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813780 -0020 City of.Zephyrhills Fire Fax - 813780 -0021 <br /> 'Permit Application <br /> Date Received Phone Contact for Permit IgiAC rim <br /> Owner's Name • /)/1J/ A2/ 9 Owner's Phone Number 1 / 4 9 /2 1 9 73 <br /> Address v n %J / !/ <br /> Owner's A ��C�f' ..it// <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee SimpleTitieholder Address I <br /> .'"„�'r.,_r^Y <<aL P({ .. „_,.. _s „C ✓.. _ ,_ _ - - - _. , -” ,,,.. .. ._.. ,.. _-,.e_ _. _» , 4 - sa'3'� §,3^,rn 'a-s t-, �FZR`3sx. <br /> Job Address Lot # <br /> Sub Division <br /> I Parcel # <br /> n Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier it or RQ Facility) ANNUAL <br /> Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> r y JSemi I [fl Other <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alann n ❑ ❑ ❑ I 1 n Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression ❑ x ❑ I 1 n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation 77 �� n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> n Flammable Application- ANNUAL I ( Valuation of Project <br /> n Fuel Tanks <br /> Q Other <br /> Contractor Company <br /> Signature Registered Y/ N j Fee Current I Y/ N <br /> Address I I License # I ( <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N 1 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 1 I . License # l ( <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current 1 Y/ N] <br /> Address 1 I License # ( <br /> OTHER rO��( C /4 ( /!2. Company <br /> Signature � `, � � 1 / jlis� � �f��5 Registered FAME Fee Current M <br /> Address e,ggma� arm License # lirliffic,0/ iJ <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 />