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, , A mio6 813 780 -0020 City of.ZephyrhillsFire Fax - 813-780 -0021 , Permit Application Date Received /00.470/ Phone Contact for Permit 91 3 162-8" 4`lcn T rrcnt .... .�y Owner's Name `4 ff 440 GI( Owner's Phone Number Owner's Address ?86,o Gam- ,L-V 0 Fee Simple Titleholder Name Titleholder Phone Number Fee Simple Titleholder Address r rammo:.A" «<, .,,, »a „a, ,: <'r.; ', -,,,. . . rk. ;mom. e :s•1,.., , .:,: >,,,,- d ". RZTO,;.,Trar".wa, i�til%,, 1 !Itr t;,;. /N.. a Job Address 7,96o 6'4 (A-- j LV Lot* Sub Division ' "7 a --P/ 4 1/ ( e 6AM-40" S Parcel # Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent Comm Exhaust Kitchen Hood /Duct I , 1 Hazardous Material (Tier I I or RQ Facility) ANNUAL Controlled Bum I Hood Installation n Emergency Generator < 30 kw n LP /Natural Gas - Installation Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale n Fire Protection Maintenance - ANNUAL I Places of Assembly- ANNUAL 1 IUtnyl ISemiI tither Sprinkler n ❑ ❑ ❑ n Recreational Bum Fire Alarm n ❑ ❑ ❑ I 1 Sparklers Hood Cleaning n ❑ ❑ ❑ IG Sprinkler System Installations ‘:...; Hood Suppression ❑ ❑ ❑ I I Standpipes (Sprinkler Sys) rn Fire Alarm Installation n Torch Roofing/Tar Kettle . Fire Pumps n Waste Tire Storage ANNUAL Fire Works Flammable Application - ANNUAL I 2'9 cep 1 Valuation of Project Fuel Tanks 1n Other: I Contractor 0(4G 71 Company C_ 4 V ,�7 U S vvc_ - Signature J`l / Registered Y / N Fee Current I Y / N Address 1 '44s r, .404 m o Da_ TPA. f`ti 33 3 1 License# ELECTRICIAN Company . Signature Registered Y/ N I Fee Current Y/ N Address I I License # I PLUMBER Company Signature Registered _ Y / N _ Fee Current 1 Y / N Address 1 License* MECHANICAL Company Signature Registered Y/ N Fee Current 1 Y / N Address 1 I License* 1 OTHER . Company Signature Registered Y/ N J Fee Current I Y / N I Address j License # Directions: Fill out application completely. Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) If over $2500, a Notice of Commencement is required .(Mechanical work over $5000) Supply two (2) sets of drawings with applicable documentation Allow 10 -14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: /lappraiser.pascogov.com).