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813 -780 -0020 City of.Zephyrhills Fire ` t7 Fax - 813 -780 -0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> Owner's Name I _ hT\ S 5TEG t< C Owner's Phone Number <br /> Owner's Address 39) - 36 S y F <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Address <br /> "T�`:%u'?.mi._7 „ - .:kM 1 . €a q ti,_.. <.:. ..k f, :_ ,.�. . -.•- ..r.. _ n. _. ,� ., -... ... .wx a„d cx , <c. `:r;..."°S X''�..d :- Y+^ua, h':"?3N'. <br /> Job Address Lot* <br /> Sub Division Parcel # <br /> Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> ED 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 Places of Assembly - ANNUAL <br /> [eirl7 'Semi Other <br /> Sprinkler El ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I I n Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I 1 n Sprinkler System Installations <br /> Hood Suppression El ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> n Flammable Application- ANNUAL ` ( Valuation of Project <br /> n Fuel Tanks <br /> A Other. I <br /> Contractor � Company <br /> Signature Registered Y / N - Fee Current I Y / N <br /> Address I I License # <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N ] Fee Current I Y/ N j <br /> Address I I License #. <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Current I Y/ N <br /> Address I I License # I I <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # <br /> OTHER Company <br /> Signature Registered Y/ N j Fee Current I Y/ N <br /> Address 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 />