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813- 780 -0020 City of.Zephyrhills Fire Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received 1 Phone C ^ on tac t for Permit I <br /> 1 .�1 <br /> Owner's Name I XA/GI G.r .✓f Owner's Phone Number (./,3 Pr 9.5 <br /> Owner's Address 37J2 GAL' C Vc vd Zepolw'Z /z ,c .9 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I I <br /> Job Address Lot # <br /> Sub Division ( Parcel # <br /> El Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> I Comm Exhaust Kitchen Hood /Duct I] Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> ri Controlled Burn I Hood Installation <br /> El Emergency Generator < 30 kw I LP /Natural Gas - Installation <br /> FT Emergency Generator > 30 kw El LP /Natural Gas - ANNUAL Sale <br /> I Fire Protection Maintenance - ANNUAL F I Places of Assembly - ANNUAL <br /> 1Qtriy) mi (j Other <br /> Sprinkler 0 ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm 7 ❑ ❑ ❑ I 1 1 1 Sparklers <br /> Hood Cleaning 56 X ❑ ❑ I n Sprinkler System Installations <br /> Hood Suppression I=1 ❑ ❑ ❑ I 1 n Standpipes (Sprinkler Sys) <br /> I Fire Alarm Installation I] Torch Roofing/Tar Kettle <br /> 1 II Fire Pumps I-) Waste Tire Storage ANNUAL <br /> n Fire Works <br /> 17 Flammable Application- ANNUAL 1 I Valuation of Project <br /> I I Fuel Tanks <br /> f ] Other: I I <br /> Contractor Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address 1 I License # I <br /> ELECTRICIAN Company I <br /> Signature I Registered Y/ N I Fee Current I Y/ N I <br /> Address I License # I <br /> PLUMBER Company I <br /> Signature Registered Y/ N J Fee Current I Y/ N <br /> Address I I License # ( I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N I Fee Current 1 Y/ N I <br /> Address I License # I <br /> OTHER Company 'oeW/7 fs.4F cus 2 <br /> Signature Registered Nam Current r�� <br /> Address] License # ��5'�CX7�S� /g'�o <br /> '? 'e x ...,'' ∎Ci., , ..•.. ,,,z,.,. :ar« s .e. a.:e� a �H.:. «.,u.I , x .uN... 1,:..4.4.4A.,,,>.,,, ,a,a :MO <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 />