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813 - 780 -0020 'City of.Zephyrhills Fire Fax- 813- 780 -0021 <br /> Permit Application <br /> Date Received — Z. Z. — Phone Contact for Permit <br /> Owner's Name I \S) �, V- Ac t K-- y_ 1- Owner s Phone Number I <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Address <br /> "� -- . ... <br /> Job <br /> 3- rQ / t-1�� c- ` �'l�Z <1-- -- 6 - .5. 1 4 . Z' Lot# <br /> Sub Division Parcel # <br /> n Bio-Hazard Waste Storage - ANNUAL = Fumigation Tent <br /> El Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum = Hood Installation <br /> n Emergency Generator < 30 kw LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL S \ <br /> CI Fire Protection Maintenance - ANNUAL n Places of Assembly -A AL � 4 <br /> M11 emi la ill O ther i , • ® i <br /> Sprinkler , ❑ ❑ n Recreational Bum 4/ <br /> Fire Alann n ❑ ❑ ❑ I I n Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I n Sprinkler System nstallati s <br /> Hood Suppression 0 ❑ ❑ ❑ I n Standpipes (Sprink Sys) <br /> Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> FT Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> FT Flammable Application- ANNUAL I I Valuation of Project <br /> I I Fuel Tanks <br /> Q Other: I <br /> Contractor Company I N f R.1E'F t c:, �f R P R2C>1 C %Q \t <br /> Signature Registered `/ N 1 Fee Current I Y / N j <br /> Address I I License # I I <br /> ELECTRICIAN Company <br /> Signature I Registered Y / N j Fee Current I Y / N J <br /> Address I I License # I <br /> PLUMBER Company <br /> Signature • Registered Y / N Fee Current I Y / N I <br /> Address I I ' License # I I <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current I Y / N J <br /> Address I 1 License # I I <br /> OTHER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N J <br /> Address License # I <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 /> • <br />