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813 -780 -0020 City of.Zephyrhills Fire / C; / <br /> Fax- 813 - 780 -0021 <br /> Permit Application t <br /> Date Received Phone Contact r Pe ` <br /> Owner's Name I2.-ty ( 1 b�_ (ty) Owner's Phone Number <br /> Owner's Address r � _ <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple'Titleholder Address 1 <br /> 4._ <br /> Job Address [ 'CD S 1.7c.-I 1 IS vd . Lot # <br /> Sub Division Parcel # O''' Lk („ dp i) -1 Gob- OD '4 1 <br /> Bio-Hazard Waste Storage - ANNUAL ED Fumigation lent <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 IP /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 print j Other /-p L %p /-/ �. <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum �A /C C��� ` <br /> ile. Fire Alarm ID ❑ ( I n Sparklers / " -6 6 <br /> Hood Cleaning n ❑ ❑ ❑ I I n Sprinkler System Installations v <br /> Hood Suppression 0 ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) � <br /> Fire Alarm Installation n Torch Roofing/Tar Kettle CV Z Se. //a <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> Flammable Application- ANNUAL I 1 Valuation of Project <br /> Fuel Tanks <br /> Q Other. 1 <br /> Contractor Company <br /> Signature Registered Y / N I Fee Current I Y/ N 1 <br /> Address I I License # I <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N 1 Fee Current I Y / N j <br /> Address I I License #. <br /> PLUMBER Company <br /> Signature Registered Y/ N J Fee Current I Y/ N I <br /> Address I 1 . License # <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current 1 Y/ N 1 <br /> Address l I License # I <br /> 11 <br /> OTHER /1 Company 1i %��Mir���3J1C�i' <br /> Signature Registered MEE ee Current [ EI <br /> Address ewi S ri Ijo _ 1 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 (httpthappraiser.pascogov.com) <br />