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813 - 780 -0020 ©. - . 1 -4 "5K "Y� J <br /> City of Zephyrhills Fire ti� Fax- 813 -780 -0021 <br /> —�— Permit Application G " <br /> Date Received , // / 1 / 7.0 Q <br /> Phone Contact for Permit <br /> Owner's Name Owner's Phone Number I I I <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address 2 ? s 4-U_ gLV D_ 60 ° 1) <br /> Lot # <br /> Sub Division Parcel # <br /> u,... >.i.. . r •.'oi.i ,y,. ,.,.;.__,... o- :,:z.acrx4i i... «. auvN .,. i wa ''£ > bra v ,.. „i.,.._.r a ..k... .,u. « .« + , ,4,. va, s.<r :a «.: „4.4. 3sPw ,,,„„,„-„: z.? <br /> n Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct I I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> I - 1 Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> ICarly' 'SemiI Other <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ I I I I Sparklers <br /> Hood Cleaning ❑ ❑ ❑ I I Sprinkler System Installations <br /> Hood Suppression n ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps I-I Waste Tire Storage ANNUAL <br /> n Fire Works <br /> El Flammable Application- ANNUAL I ( (cD I Valuation of Project <br /> I — I Fuel Tanks <br /> n Other: I <br /> qa.a _,....._.« ,.., ..ate.. €'d., . ..:;anima, a ,•„.rt'OSA '.<fisAR:i0 •.... •. . pie.:.. w2',.sai.I°ri.` WAR C:,i ;' %4 a.lk.': =. .:a 's&e3.::. ✓. `...iC..,.,ME.:== v :i. �ZA A.«1.:u: <br /> Contractor , ■ Company C *1'.SC0 -P4D"/ S`i -S C <br /> Signature ,/ Registered WAIN Fee Current 1'0 N <br /> Address att►LT ] / /, 010 Pt. i ?4Yi- T JI /A, Ft 33` / I License # I 1” 0 +4'c - C> 00) 7.005 I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I 1 License # I <br /> PLUMBER Company <br /> Signature Registered Y / N j Fee Current I Y / N I <br /> Address I I License # I <br /> MECHANICAL Company <br /> Signature Registered Y / N j Fee Current I Y / N I <br /> Address I I License # <br /> OTHER Company <br /> Signature Registered Y / N I Fee Current I Y / N I <br /> Address I I License # 1 <br /> 'Es'7's,'.3'�.+; .....vK....nn w w ...s.. :tc�.ar.a�...., ...., �;:a:*.,sass _c.,,.:.sa.....,w...x.�?+. +'.5 :-;:• " ..._,.Gc...... :: <br /> Directions: <br /> Fit 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 />