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813-780-0020 City of Zephyrhills Fire 14-9av <br /> Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received /0 ••• 9-- Oq n <br /> Phoe Contactfor Permit <br /> 913 I t)1 <br /> Owner's Name C MIA/ 4 3119 a. k 'ZE PNYR. Co.• fAoIS Owner's Phone Number n 7 -Sat_ <br /> 0073 <br /> Owner's Address 74 GALL Qls sib # 8-S <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> Job Address ?Q 4 4 0 GALL- 4 j. VA „ 0 6 -3" Lot # <br /> Sub Division Parcel # <br /> et 2S'- 2 1-0130 - -bQ000 <br /> I Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier 11 or RQ Facility) ANNUAL <br /> I Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> FT Emergency Generator> 30 kw I LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL J �� <br /> )lltrlyi lsemiI ffl Uther / <br /> Sprinkler n ❑ ❑ ❑ I. Recreational Bum / <br /> Fire Alarm 1 O1 ❑ ❑ ❑ I I Sparklers I / ' <br /> Hood Cleaning El ❑ ❑ ❑ I n Sprinkler System Installa 'ons <br /> Hood Suppression ❑ ❑ ❑ I n Standpipes (Sprinkler Sys <br /> Fire Alarm Installation 1 tw o A .b Mp►rto>R AA Torch Roofing/Tar Kettle . , 0 <br /> n �, <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> n flammable Application- ANNUAL ) 1 . oo • I Valuation of Project <br /> Fuel Tanks � c9 <br /> n Other: I <br /> Contractor <br /> Company <br /> Signature Registered Y / N _ Fee Current I Y / N <br /> Address I <br /> License # I <br /> ELECTRICIAN Company <br /> Signature Registered Y / N j Fee Current I Y / N 1 <br /> Address <br /> I License # <br /> PLUMBER Company <br /> Signature Registered Y1-N1 . Fee Current I Y / N <br /> Address I <br /> I License # I I <br /> MECHANICAL Company <br /> Signature Registered Y / N 1 Fee. Current I Y / N <br /> Address I . I License # <br /> OTHER . iL Company FAA Assi t, f Sitcri *' 1t � <br /> 4 <br /> Signature Registered Y / N I Fee Current Y/ N <br /> Address Y I. l , ./ . 1 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 />