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813 -780 -0020 City of.Zephyrhils Fire , i 109 / 1 Fax - 813- 780 -0021 <br /> Permit Application • i <br /> Date Received J Phone Contact for Permit <br /> Owner's Name 1 0 1.. /'i 0 7 0 6 Owner's Phone Number 1 1 1 <br /> Owner's Address G 4 LI 4 L.:, Z 0 or t I 7=1 3) j ' / <br /> Fee Simple Titleholder Name Titleholder Phone Number 1 1 1 <br /> Fee SimpleTitleholder Address I <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> n Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> I—I 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 n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> ❑ � � emi ( OA Other <br /> Sprinkler ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I ( n Sparklers <br /> Hood Cleaning E ❑ ❑ ❑ ( n Sprinkler System Installations <br /> Hood Suppression E ❑ ❑ ❑ ( ( n Standpipes (Sprinkler Sys) <br /> FT Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> ED Flammable Application- ANNUAL <br /> 1 I Valuation of Project <br /> n Fuel Tanks <br /> Q Other. I <br /> . <br /> Contractor ' <br /> Company <br /> Signature _4 Registered Y / N ] Fee Current I Y / N <br /> Address I I License # I <br /> ELECTRICIAN <br /> Company <br /> Signature I Registered Y/ N I Fee Current I Y / N j <br /> Address I I License #. I I <br /> PLUMBER Company <br /> Signature Registered Y/ N j Fee Current I Y/ N j <br /> Address I I . License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N j Fee Current I Y / N J <br /> Address I I License # <br /> OTHER <br /> Company <br /> Signature Registered Y / N 1 Fee Current I Y/ N 1 <br /> r Address License # <br /> Directions: _ r <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 />