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B1379-0C.0 City of.Zephyrhills Fire 1 S7 Fax - 813- 780-0021 <br /> 'Permit Application �t <br /> Date Received j Phone Contact for Permit - 1 <br /> Owner's Name r7/ bic Owner's Phone Number F/2) 775 1 / 57 <br /> Owner's Address 6 (71ttt`_. / '2 t s!,a ( ) /�/ J//5 NL A3 / <br /> Fee Simple Titleholder Name f f Titleholder Phone Number <br /> Fee SimpleTitieholder Address I <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> n 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 /> n Controlled Burn n Hood Installation <br /> n Emergency Generator < 30 kw Ti LP /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 /> min r emm [E] Uther <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I I n Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ 1 I n Sprinkler System Installations <br /> Hood Suppression 0 ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> Fire Pumps 1:rWaste Tire Storage ANNUAL d <br /> Fire Works k t 4eily Trke <br /> Flammable Application- ANNUAL ' 1 Valuation f Project <br /> y <br /> F u anks <br /> n er: L . , <br /> ;dTS7'yr0;. x• - :, .....`. -„. R. e4� <br /> nAramirowswar Contractor i � /� , . .,, Company <br /> Signature Registered Y / N Fee Current Y / N <br /> Address I ( License # <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N . 1 Fee Current I Y/ N J <br /> Address I I License # I <br /> PLUMBER Company <br /> Signature Registered Y/ N . 1 Fee Current I Y/ N j <br /> Address I I . License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current 1 Y/ N I <br /> Address I I License # i <br /> OTHER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N j <br /> Address License # <br /> Directions: <br /> • <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 />